CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Saint Mary's Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $166
  • Cash Discount Price: $119
  • vs. Medicare Baseline: 5.99x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Saint Mary's Hospital is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 5.99x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$119

Average discount available for prompt cash payment at this facility.

Insurance Median
$166

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: $119 (429%)
Insurance Median: $166 (599%)
Cash: $119 (429% of Medicare)
Ins. Median: $166 (599% 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 599% of the Medicare baseline (a markup of 499%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $26 - $34 94%
Aetna $29 - $171 105%
Cca Senior Care Options $29 105%
Medicare (plans) $29 105%
UnitedHealthcare $29 - $314 105%
Cigna $30 - $336 108%
Bcn Domestic $34 123%
Blue Benefit Administrators of Massachusetts $34 123%
Blue Care Network $34 123%
Blue Distinction Transplant $34 123%
Blue Shield - Ca $34 123%
Blue Shield - Id (Regence) $34 123%
Blue Shield - Ny Highmark Northeastern $34 123%
Blue Shield - Ny Highmark Western $34 123%
Blue Shield - PA (Highmark) $34 123%
Blue Shield - Wa (Regence) $34 123%
Health Choices $34 123%
Kaiser Domestic $34 123%
Pre-Employment $34 123%
Unicare $34 123%
Wc Domestic $34 123%
Wellpoint $34 123%
Connecticut Dept of Correction $54 195%
Centivo $58 209%
Claimdoc $61 220%
Diversified Administrators $61 220%
Innovative Health Plan II $61 220%
Carelon Behavioral Health $108 390%
Health New England $115 415%
Allied National Global Care $166 599%
Asrm - Reliance Standard Life Insurance $166 599%
Christian Care Ministry $166 599%
Dean Health $166 599%
Fallon Health $166 599%
Family Life Insurance Company $166 599%
Ghc Scw $166 599%
International Benefit Administrators $166 599%
Lifetime Benefit Solutions $166 599%
Manhattan Life $166 599%
Medi Share $166 599%
Multiplan $166 599%
Mvp $166 599%
PHCS $166 599%
Pai $166 599%
Pan-American Life $166 599%
Paramount HMO $166 599%
Trinity Health Share $166 599%
1199 National Benefit Fund $171 617%
Allied Benefit Systems $171 617%
Gravie Admin Services $171 617%
Hap $171 617%
Luminare Health $171 617%
Meritain $171 617%
Nippon Life Ins $171 617%
Webtpa $171 617%
Prime Health Services $173 624%
Health Smart $184 664%
Connecticare $212 - $219 765%
United Behavioral Health Eap $216 779%
Geha $314 1133%
Harvard Pilgrim Healthcare $314 1133%
Allegiance $336 1212%
Health Partners $336 1212%
Magnacare $336 1212%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals