CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Carle Health Pekin Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $49
Cash Discount Price: $194
vs. Medicare Baseline: 1.77x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Carle Health Pekin Hospital is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $194. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.77x the Medicare baseline. Located in 600 South 13Th Street, Pekin, IL.

Cash / Self-Pay

$194

Average discount available for prompt cash payment at this facility.

Insurance Median

$49

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: $194 (700%)

Insurance Median: $49 (177%)

Cash: $194 (700% of Medicare)

Ins. Median: $49 (177% 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	$20 - $97	72%
Humana	$20 - $27	72%
Blue Cross Blue Shield	$27 - $77	97%
Molina	$27 - $58	97%
UnitedHealthcare	$27 - $28	97%
Wellcare	$27	97%
Meridian	$31	112%
Multiplan/Phcs	$97	350%
Healthlink	$107 - $126	386%
Cigna	$130	469%

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 $194.
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 Carle Health Pekin 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.