CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Spanish Peaks Regional Health Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $53
Cash Discount Price: $93
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Spanish Peaks Regional Health Center is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.91x the Medicare baseline. Located in 23500 Us Highway 160, Walsenburg, CO.

Cash / Self-Pay

$93

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$27.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $27.72 (100%)

Cash / Self-Pay: $93 (335%)

Insurance Median: $53 (191%)

Cash: $93 (335% of Medicare)

Ins. Median: $53 (191% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $27.72 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Humana	$29 - $53	105%
Kaiser Ppo Mcr	$29 - $109	105%
Medicare (plans)	$29 - $53	105%
UnitedHealthcare	$29 - $101	105%
Devoted Health Mcr - All Plans	$30 - $56	108%
Apostrophe - All Plans	$37 - $98	133%
Blue Cross Blue Shield	$37 - $98	133%
Cofinity - All Plans	$37 - $100	133%
Connect For Health - All Plans	$37 - $101	133%
Friday Hp Chp - All Plans	$37 - $98	133%
Prov Ntwrk Of America - All Plans	$40 - $98	144%
Rmhp - All Plans	$43 - $101	155%
Kaiser Ppo - All Other Plans	$46 - $98	166%
Beacon Health Op Only-All Plans	$56 - $97	202%
Cigna	$87 - $98	314%
Multiplan Phcs - All Plans	$87 - $104	314%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $93.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97140.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Spanish Peaks Regional Health Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97140.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.