CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Witham Health Services

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $160
Cash Discount Price: $126
vs. Medicare Baseline: 5.77x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Witham Health Services is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 5.77x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$126

Average discount available for prompt cash payment at this facility.

Insurance Median

$160

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: $126 (455%)

Insurance Median: $160 (577%)

Cash: $126 (455% of Medicare)

Ins. Median: $160 (577% 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 577% of the Medicare baseline (a markup of 477%). 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
Aetna	$27 - $164	97%
Blue Cross Blue Shield	$27 - $222	97%
Caresource Mcr Adv	$27	97%
Mdwise Health In-All Plans	$27	97%
Caresource Indiana Marketplace-All Other Plans	$51	184%
UnitedHealthcare	$125 - $173	451%
Humana	$149 - $201	538%
Phcs/Multiplan-All Plans	$149 - $202	538%
Beech Street-All Plans	$150 - $208	541%
Sagamore-All Plans	$151 - $204	545%
Encore-All Plans	$156 - $210	563%
Mhs Comml Exch-All Plans	$400 - $554	1443%

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 $126.
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 Witham 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.