CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Northwest Health - Starke

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $149
  • Cash Discount Price: $83
  • vs. Medicare Baseline: 5.38x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Northwest Health - Starke is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 5.38x the Medicare baseline. Located in 102 E Culver Rd, Knox, IN.
Cash / Self-Pay
$83

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: $83 (299%)
Insurance Median: $149 (538%)
Cash: $83 (299% 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.

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
UnitedHealthcare $24 - $186 87%
Tricare $25 90%
Aetna $26 - $214 94%
Blue Cross Blue Shield $26 - $186 94%
Humana $26 - $186 94%
Medicare (plans) $26 94%
Node Champva $26 94%
Managed Health Services $27 - $186 97%
Node Devoted Health Mcr Adv $27 97%
Node Hospice Non Par Agree $27 97%
Node Va $27 97%
One Call $27 97%
In Dept Of Correction $28 101%
Node Pphp Mcr Adv $28 101%
Us Department Of Labor $40 144%
Encore $48 - $215 173%
Lutheran $48 - $67 173%
Self Pay $48 - $136 173%
Indiana Workers Comp $53 191%
Lutheran Network $53 - $217 191%
Medpartners $60 - $83 216%
Encore Kba Epo $64 231%
Magnacare Ma $64 231%
Physicians Health Plan $74 - $102 267%
Encore Kba Ppo $80 289%
Alpha Baking $81 - $111 292%
Php $108 - $149 390%
Caresource $143 - $186 516%
Multiplan Inc $143 - $222 516%
Cigna $149 - $205 538%
Coventry First Health $155 - $214 559%
Sagamore Health Network $158 - $217 570%
Community Health Alliance $161 - $222 581%
Ppom $168 - $232 606%
Medicaid / KanCare $186 671%
Mhs $186 671%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 102 E Culver Rd, Knox, IN 46534
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals