CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Franklin General Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $74
Cash Discount Price: $112
vs. Medicare Baseline: 2.67x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Franklin General Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.67x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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: $112 (404%)

Insurance Median: $74 (267%)

Cash: $112 (404% of Medicare)

Ins. Median: $74 (267% 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 267% of the Medicare baseline (a markup of 167%). 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
Amerigroup Mcare	$50	180%
Medical Associates Mcare	$50	180%
Mount Carmel Hp-All Plans	$50	180%
Tricare	$50	180%
UnitedHealthcare	$50 - $103	180%
Wellmark Mcr Adv	$50	180%
Ambetter / Centene	$52 - $79	188%
American Hp Iowa - All Plans	$52	188%
Amerigroup Mcaid - All Other Plans	$52	188%
Molina Mcare	$52	188%
Molina Mcaid - All Other Plans	$53	191%
Centivo - All Plans	$74	267%
Medical Ass Hosp Employer Group	$74	267%
Oscar - All Plans	$74	267%
Midlands Choice-All Plans	$87	314%
Medical Associates Hp-All Other Plans	$105	379%
Preferred Health Choices-All Plans	$105	379%
Splashlight Llc-All Plans	$105	379%
Aetna	$115 - $118	415%
Multiplan-All Plans	$118	426%
Wellmark Hmo	$136	491%
Wellmark Ppo - All Other Plans	$150	541%

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 $112.
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 Franklin General 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.