CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Sartori Memorial Hospital, Inc

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $53
Cash Discount Price: $1,407
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Sartori Memorial Hospital, Inc is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,407. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.91x the Medicare baseline. Located in 515 College Street, Cedar Falls, IA.

Cash / Self-Pay

$1,407

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $1,407 (5076%)

Insurance Median: $53 (191%)

Cash: $1,407 (5076% of Medicare)

Ins. Median: $53 (191% 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
Iowa Total Care	$24	87%
Medicaid / KanCare	$24	87%
Aetna	$26 - $302	94%
Blue Cross Blue Shield	$26	94%
Medicare (plans)	$26 - $27	94%
UnitedHealthcare	$27 - $284	97%
Amish Hospital Aid	$35	126%
Oscar	$41	148%
Centivo	$44	159%
Ambetter / Centene	$45	162%
Health Choices	$48	173%
Medical Associates	$48	173%
Claimdoc	$53	191%
Nova	$53	191%
Health Partners	$67	242%
Auxiant	$145	523%
Cigna	$145	523%
Medica	$145	523%
Midlands	$145	523%
Midlands Choice	$145	523%
Iowa Dept Of Public Health	$204	736%
Geha	$284	1025%
Allied Benefit Systems	$302	1089%
Asr Health Benefits	$302	1089%
Coventry	$302	1089%
First Health	$302	1089%
Lucent Health	$302	1089%
Luminare Health	$302	1089%
Medical Mutual	$302	1089%
Meritain	$302	1089%
Webtpa	$302	1089%

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 $1,407.
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 Sartori Memorial Hospital, Inc 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.