CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Norton-King's Daughters' Health

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $166
Cash Discount Price: $43
vs. Medicare Baseline: 5.99x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Norton-King's Daughters' Health is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 5.99x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$166

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: $43 (155%)

Insurance Median: $166 (599%)

Cash: $43 (155% of Medicare)

Ins. Median: $166 (599% 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 599% of the Medicare baseline (a markup of 499%). 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	$22 - $90	79%
Aetna	$26 - $176	94%
Humana	$26 - $90	94%
UnitedHealthcare	$26 - $157	94%
Managed Health Services	$27 - $40	97%
Caresource Of Kentucky	$36	130%
Caresource Of Indiana	$39	141%
Custom Design Benefits	$52 - $100	188%
Managed Health Services Of Kentucky	$85 - $90	307%
Passport By Molina	$85 - $90	307%
Cigna	$161 - $170	581%
Encore	$161 - $170	581%
Quality Care Partners	$168 - $178	606%
Bluegrass	$170 - $180	613%
First Health	$170 - $180	613%
Healthlink	$170 - $180	613%
Vha/Tristate	$170 - $180	613%
Multiplan/Phcs	$174 - $184	628%
Indiana Health Network	$180 - $190	649%
Siho	$180 - $190	649%

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 $43.
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 Norton-King's Daughters' Health 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.