CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: HCA Healthone Spalding Rehabilitation

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $80
Cash Discount Price: $332
vs. Medicare Baseline: 2.89x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at HCA Healthone Spalding Rehabilitation is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $332. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.89x the Medicare baseline. Located in 900 Potomac St, Aurora, CO.

Cash / Self-Pay

$332

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $332 (1198%)

Insurance Median: $80 (289%)

Cash: $332 (1198% of Medicare)

Ins. Median: $80 (289% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 289% of the Medicare baseline (a markup of 189%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$25 - $215	90%
Blue Cross Blue Shield	$25 - $288	90%
Bright Health	$25 - $29	90%
Cigna	$25 - $271	90%
Devoted Health	$25 - $29	90%
Humana	$25 - $28	90%
Mutual Of Omaha	$25 - $29	90%
Rocky Mountain Health	$25 - $29	90%
Total Longterm Care	$25 - $29	90%
Triwest Health Alliance	$25 - $339	90%
United	$25 - $191	90%
Delaware Life Insurance	$26 - $30	94%
Innovage Pace	$26 - $29	94%
Kaiser	$26 - $253	94%
Wellcare	$26 - $30	94%
Vail Health	$36 - $64	130%
Western Plains Community Health	$156 - $276	563%
Multiplan	$168 - $382	606%
Pinnacol Workers Comp	$180 - $318	649%
Prime Health	$215 - $382	776%

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 $332.
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 HCA Healthone Spalding Rehabilitation 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.