CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Morton Plant North Bay Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $56
Cash Discount Price: $70
vs. Medicare Baseline: 2.02x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Morton Plant North Bay Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.02x the Medicare baseline. Located in 6600 Madison Street, New Port Richey, FL.

Cash / Self-Pay

$70

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

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: $70 (253%)

Insurance Median: $56 (202%)

Cash: $70 (253% of Medicare)

Ins. Median: $56 (202% 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 202% of the Medicare baseline (a markup of 102%). 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
Molina	$12 - $97	43%
Simply Healthcare	$12 - $30	43%
Freedom	$14 - $33	51%
Optimum	$14 - $33	51%
Careplus	$16 - $37	58%
Aetna	$20 - $134	72%
Baycareplus	$20	72%
Blue Cross Blue Shield	$20 - $87	72%
Avmed	$21 - $80	76%
Ultimate Health Plan	$21 - $49	76%
Clear Health Alliance	$22	79%
UnitedHealthcare	$22 - $148	79%
Freedom Health	$23	83%
Humana	$23 - $26	83%
Molina Healthcare	$23	83%
Solis Health	$23	83%
Sunshine Health	$23	83%
Cigna	$24 - $143	87%
Florida Community Care	$24	87%
Wellcare	$29	105%
Evolutions	$34 - $153	123%
Ambetter / Centene	$46 - $164	166%
First Health	$59 - $139	213%
Multiplan	$62 - $148	224%
United Behavioral Health	$69 - $164	249%

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 $70.
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 Morton Plant North Bay 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.