CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Kootenai Health

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $35
Cash Discount Price: $92
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Kootenai Health is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.26x the Medicare baseline. Located in 2003 Kootenai Health Way, Coeur D'Alene, ID.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

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: $92 (332%)

Insurance Median: $35 (126%)

Cash: $92 (332% of Medicare)

Ins. Median: $35 (126% 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
Coordinated Care Of Washington	$16	58%
Molina Healthcare Of Idaho	$16 - $45	58%
Molina Healthcare Of Washington	$16	58%
Magellan	$24	87%
Wellpoint	$24	87%
Aetna	$26 - $101	94%
Blue Cross Blue Shield	$26 - $110	94%
Humana	$26	94%
Premera	$26 - $75	94%
Regence Blue Shield Of Idaho	$26 - $27	94%
UnitedHealthcare	$26 - $110	94%
Pacificsource	$27 - $100	97%
Group Health/Kaiser	$40 - $95	144%
Mountain Health Co-Op	$95	343%
Cigna	$100 - $101	361%
First Choice Health (Ameriben)	$104 - $106	375%
Interwest Health	$104	375%

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 $92.
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 Kootenai Health 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.