CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Warner Hospital and Health Services

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $149
Cash Discount Price: $185
vs. Medicare Baseline: 5.38x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Warner Hospital and Health Services is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 5.38x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$185

Average discount available for prompt cash payment at this facility.

Insurance Median

$149

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: $185 (667%)

Insurance Median: $149 (538%)

Cash: $185 (667% of Medicare)

Ins. Median: $149 (538% 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 538% of the Medicare baseline (a markup of 438%). 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	$70 - $190	253%
Aetna	$72 - $165	260%
Health Alliance Med Adv	$72 - $79	260%
Humana	$72 - $165	260%
Molina Mcr/Mcd Dual	$72 - $79	260%
UnitedHealthcare	$72 - $165	260%
Wellcare Mcr Adv-All Plans	$72 - $79	260%
Harmony Hp Mcaid-All Plans	$137	494%
Healthlink Hmo	$137 - $151	494%
Medicaid / KanCare	$137	494%
Meridian Hp-All Plans	$137	494%
Molina-All Other Plans	$137	494%
City Of Clinton (Employees Serv)-All Plans	$140 - $155	505%
Cigna	$146 - $161	527%
Caterpillar-All Plans	$149 - $165	538%
Multiplan Phcs-All Plans	$149 - $165	538%
Health Alliance-All Other Plans	$154 - $170	556%
Healthlink Ppo/Work Comp-All Other Plans	$154 - $170	556%
Consociate Care Ppo-All Plans	$158 - $174	570%
Hfn Ppo/Epo-All Plans	$158 - $174	570%
Three Rivers-All Plans	$167 - $184	602%

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 $185.
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 Warner Hospital and Health Services 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.