CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Winter Haven Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $76
Cash Discount Price: $98
vs. Medicare Baseline: 2.74x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Winter Haven Hospital is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.74x the Medicare baseline. Located in 200 Ave F Ne, Winter Haven, FL.

Cash / Self-Pay

$98

Average discount available for prompt cash payment at this facility.

Insurance Median

$76

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: $98 (354%)

Insurance Median: $76 (274%)

Cash: $98 (354% of Medicare)

Ins. Median: $76 (274% 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 274% of the Medicare baseline (a markup of 174%). 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	$20 - $134	72%
Baycareplus	$20	72%
Blue Cross Blue Shield	$20 - $95	72%
Clear Health Alliance	$22	79%
UnitedHealthcare	$22 - $148	79%
Freedom Health	$23	83%
Humana	$23 - $26	83%
Molina Healthcare	$23	83%
Simply Healthcare	$23 - $30	83%
Solis Health	$23	83%
Sunshine Health	$23	83%
Cigna	$24 - $143	87%
Florida Community Care	$24	87%
Health First	$24	87%
Careplus	$29	105%
Wellcare	$29	105%
Molina	$30 - $97	108%
Freedom	$32	115%
Optimum	$32	115%
Ambetter / Centene	$46 - $164	166%
Ultimate Health Plan	$49	177%
Avmed	$51 - $80	184%
Florida Hospital	$75	271%
Evolutions	$82 - $153	296%
Multiplan	$131	473%
First Health	$139	501%
United Behavioral Health	$164	592%

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 $98.
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 Winter Haven Hospital 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.