CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Lower Keys Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $224
  • Cash Discount Price: $108
  • vs. Medicare Baseline: 8.08x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Lower Keys Medical Center is $224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 8.08x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$108

Average discount available for prompt cash payment at this facility.

Insurance Median
$224

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: $108 (390%)
Insurance Median: $224 (808%)
Cash: $108 (390% of Medicare)
Ins. Median: $224 (808% 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 808% of the Medicare baseline (a markup of 708%). 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
Molina $20 72%
Tricare $27 97%
Veterans Eval Services $27 97%
Blue Cross Blue Shield $28 - $350 101%
Humana $28 101%
Medicare (plans) $28 101%
Node Champva $28 101%
Ultimate Health $28 101%
Node Non Par Hospice Agree $29 105%
Node United Behavioral Va Ccn $29 105%
Node Va $29 105%
UnitedHealthcare $29 - $269 105%
Correct Care Solutions $32 115%
Node Us Dept Of Labor $43 155%
Prime Health Work Comp Fl $48 173%
Fl Work Comp $49 177%
Heritage Summit Work Comp Fl $49 177%
State Auto Insurance Fl $58 209%
Self Pay $94 - $122 339%
Simply Healthcare $108 390%
Cigna $206 743%
Aetna $244 880%
Monroe County $262 945%
Evolutions Healthcare Systems $280 - $332 1010%
Keys Energy $280 1010%
Prime Health Ppo $280 1010%
Avmed Health Plan $297 1071%
Direct Healthcare $350 1263%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals