CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Caribou Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $105
Cash Discount Price: $77
vs. Medicare Baseline: 3.79x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Caribou Medical Center is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.79x the Medicare baseline. Located in 300 South 3Rd West, Soda Springs, ID.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $77 (278%)

Insurance Median: $105 (379%)

Cash: $77 (278% of Medicare)

Ins. Median: $105 (379% 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 379% of the Medicare baseline (a markup of 279%). 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
Blue Cross Blue Shield	$50 - $108	180%
Humana	$50	180%
Pacific Source Mcr Adv	$50	180%
Regence Blue Shield Mcr	$50	180%
Select Health Mcr Adv	$50	180%
Select Health/Bright Path Mcr Adv	$50	180%
Aetna	$69 - $108	249%
First Choice Health-All Plans	$99	357%
Bc Qualified Hp (Qhp)	$102	368%
Deseret Healthcare-All Plans	$104	375%
Pacific Source-All Other Plans	$107	386%
UnitedHealthcare	$107	386%
Cigna	$108	390%
Montana Health Co-Op-All Plans	$108	390%
Regence Blue Shield-All Other Plans	$108	390%
Select Health-All Other Plans	$108	390%

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 $77.
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 Caribou 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.