CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: University of Miami Hospital and Clinics

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $270
Cash Discount Price: $113
vs. Medicare Baseline: 9.74x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at University of Miami Hospital and Clinics is $270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 9.74x the Medicare baseline. Located in 1475 Nw 12Th Ave Suite 2175, Miami, FL.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$270

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: $113 (408%)

Insurance Median: $270 (974%)

Cash: $113 (408% of Medicare)

Ins. Median: $270 (974% 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 974% of the Medicare baseline (a markup of 874%). 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
Careplus	$96 - $112	346%
Sunshine Health	$96 - $112	346%
Molina Healthcare Of Fl	$104 - $122	375%
Amerihealth Caritas Fl	$108 - $126	390%
Oscar Health Of Fl	$108 - $126	390%
Aetna	$134 - $247	483%
UnitedHealthcare	$171 - $303	617%
Curative	$204 - $238	736%
Employers Health Network	$230 - $270	830%
Simply Healthcare	$230 - $270	830%
Cigna	$249 - $300	898%
First Health	$250 - $292	902%
Health First New York Health Insurance	$250 - $292	902%
Broward Health	$269 - $315	970%
Avmed	$281 - $323	1014%
Beech Street	$307 - $360	1108%
Dimension Health	$307 - $360	1108%
Multiplan	$307 - $360	1108%
Blue Cross Blue Shield	$373 - $884	1346%

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 $113.
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 University of Miami Hospital and Clinics 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.