CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Alton Memorial Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $101
Cash Discount Price: $81
vs. Medicare Baseline: 3.64x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Alton Memorial Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.64x the Medicare baseline. Located in One Memorial Drive, Alton, IL.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $81 (292%)

Insurance Median: $101 (364%)

Cash: $81 (292% of Medicare)

Ins. Median: $101 (364% 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 364% of the Medicare baseline (a markup of 264%). 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
Aetna	$26 - $332	94%
Blue Cross Blue Shield	$26 - $216	94%
Essence Healthcare [221]	$26	94%
Humana	$26 - $75	94%
UnitedHealthcare	$26 - $127	94%
Cox Health [757]	$28	101%
Devoted Health Plan [847]	$28	101%
Medica [662]	$28	101%
Healthlink [225]	$65 - $102	234%
Cox Health Systems Insurance Company [220]	$74 - $88	267%
Health Alliance [224]	$74	267%
Allied Benefits [498]	$78 - $332	281%
Hope Trust [806]	$78	281%
Med-Pay [480]	$88 - $101	317%
Unicare [568]	$88 - $102	317%
First Health Commercial [734]	$100	361%
Beechstreet [551]	$101	364%
Detego Health [868]	$101	364%
Health Systems Inc [620]	$101	364%
Healthcare Sol Mercy [609]	$101	364%
Multiplan Commercial [737]	$101	364%
Multiplan [240]	$101	364%
Phcs [244]	$101 - $108	364%
Preferred Health Professionals [561]	$102	368%
Cigna	$108 - $328	390%
Hfn [563]	$108	390%
Medica [661]	$108	390%
Healthscope Benefits [258]	$127	458%
Consociate [478]	$237	855%
Sarah Bush Lincoln [636]	$237	855%
Apwu Health Plan [216]	$328	1183%
Nalc Health Benefit Plan [242]	$328	1183%
Priority Health [648]	$328	1183%
Coresource [497]	$332	1198%
Fmh Benefit Service Inc [222]	$332	1198%
Mail Handlers [495]	$332	1198%

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 $81.
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 Alton Memorial 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.