CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Southern Regional Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $29
Cash Discount Price: $28
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Southern Regional Medical Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.05x the Medicare baseline. Located in 11 Upper Riverdale Road, Sw, Riverdale, GA.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$29

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: $28 (101%)

Insurance Median: $29 (105%)

Cash: $28 (101% of Medicare)

Ins. Median: $29 (105% 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.

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	$18 - $28	65%
Humana	$27 - $53	97%
Americas Choice Provider Network	$28	101%
Blue Cross Blue Shield	$28 - $177	101%
Cigna	$28 - $48	101%
Clear Spring Health Plan	$28	101%
Corvel	$28	101%
Georgia Workers’ Compensation	$28	101%
Medicare (plans)	$28	101%
Multiplan	$28	101%
Novanet	$28	101%
Prime Health Services	$28	101%
Provider Select	$28	101%
Riverwood Behavioral Health	$28 - $35	101%
Three Rivers	$28	101%
Tricare	$28	101%
UnitedHealthcare	$28	101%
Caresource	$29 - $49	105%
Devoted Health	$29	105%
Peach State	$29 - $34	105%
Sonder Health Plan	$29	105%
Wellcare	$29	105%
Oscar Health Plan	$36	130%
Employer Direct Healthcare	$39	141%
Centurion	$42	152%
Naphcare	$43	155%
Therapy Network Of Ga	$239	862%

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 $28.
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 Southern Regional Medical Center 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.