CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Mt Sinai Hospital Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $46
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Mt Sinai Hospital Medical Center is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.66x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $74 (267%)
Insurance Median: $46 (166%)
Cash: $74 (267% of Medicare)
Ins. Median: $46 (166% 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.

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
Partners In Hlth - All Plans $23 - $62 83%
Blue Cross Blue Shield $26 - $231 94%
Cigna $27 - $243 97%
Tricare $27 97%
Va Healthnet - All Plans $27 97%
Advocate Physician Prtnrs Mcr $28 101%
Cenpatico Illinicare Dual $28 101%
Cenpatico Illinicare Mcr - All Other Plans $28 101%
Humana $28 - $485 101%
Lawndale Christian - All Plans $28 101%
Meridian/Harmony D-Snp - All Plans $28 101%
Nextlevel Hlth Icp Fhp Aca - All Plans $28 101%
UnitedHealthcare $28 - $171 101%
Harmony Behavioral Htlh - All Plans $29 105%
Zing Mcr Adv - All Plans $29 105%
Molina Mcr - All Other Plans $30 108%
Oscar - All Plans $30 - $64 108%
Advocate Physician Prtnrs - All Other Plans $31 112%
Ambetter / Centene $31 - $162 112%
Compsych Ip/Op Only - All Plans $35 - $93 126%
Healthlink Hmo $38 - $100 137%
Hfn Platinum $38 - $100 137%
Healthlink Ppo - All Other Plans $41 - $108 148%
Multiplan Primary Ntwrk/Phcs - All Other Plans $41 - $108 148%
Hfn Epo $46 - $123 166%
Multiplan Complementary Ntwrk $46 - $123 166%
Hfn Ppo - All Other Plans $51 - $136 184%
Aetna $131 - $349 473%
Family Health Network Mcaid - All Plans $231 833%
Molina Mcaid $243 877%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals