CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Washington County Hospital and Clinics

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $39
Cash Discount Price: $71
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Washington County Hospital and Clinics is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.41x the Medicare baseline. Located in 400 East Polk Street, Washington, IA.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $71 (256%)

Insurance Median: $39 (141%)

Cash: $71 (256% of Medicare)

Ins. Median: $39 (141% 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	$34 - $102	123%
Blue Cross Blue Shield	$37 - $249	133%
Health Alliance Mcr Adv	$37 - $38	133%
Med Assoc Mcr Adv	$37 - $38	133%
Healthpartners Mcr Adv	$38 - $39	137%
Humana	$38 - $39	137%
Ia Total Care Wellcare Mcr Adv	$38 - $40	137%
Molina Mcr Adv - All Other Plans	$38 - $40	137%
Wellpoint Mcr Adv Amerigrp - All Other Plans	$38 - $40	137%
Ambetter / Centene	$39	141%
Ia Total Care Mcaid	$39 - $40	141%
Medicaid / KanCare	$39 - $40	141%
Wellpoint Mcaid Amerigrp	$39 - $40	141%
Healthpartners - All Other Plans	$78 - $82	281%
Midlands Choice - All Plans	$78 - $82	281%
Health Alliance Comm - All Other Plans	$87 - $91	314%

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 $71.
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 Washington County 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.