Physical therapy (manual therapy)
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $27
- Cash Discount Price: $75
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 - $70 | 79% |
| Medicaid / KanCare | $22 - $26 | 79% |
| Aetna | $24 - $99 | 87% |
| Humana | $24 - $25 | 87% |
| UnitedHealthcare | $24 - $78 | 87% |
| Kindful Hospice Contracted [320434] | $25 | 90% |
| Cross Timbers Hospice [20098] | $25 | 90% |
| Tricare | $25 | 90% |
| Pace Of The Ozarks Contracted [320518] | $25 | 90% |
| Halo Hcr Inc Hospice [20432] | $25 | 90% |
| Kindful Hospice [20434] | $25 | 90% |
| Elara Caring Aspire Hospice [20433] | $25 | 90% |
| Dept Of Veteran Affairs Contracted [320106] | $25 | 90% |
| Medicare (plans) | $25 | 90% |
| Halo Hcr Inc Hospice Contracted [320432] | $25 | 90% |
| Mercy Hospice Okc [20252] | $25 | 90% |
| Home State Health Plan Contracted [320187] | $26 | 94% |
| Ambetter / Centene | $26 | 94% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $27 | 97% |
| Medica Contracted [320239] | $42 | 152% |
| Health Choice Contracted [320166] | $43 | 155% |
| Providrs Care Network Contracted [320484] | $49 | 177% |
| United Medical Resources Contracted [320454] | $78 | 281% |
| Cigna | $80 - $89 | 289% |
| Aither Health Contracted [320449] | $93 | 335% |
| Workers Comp [20426] | $93 | 335% |
| Ebms Contracted [320493] | $93 | 335% |
| Edison Health Solutions Contracted [320502] | $93 | 335% |
| Mercy Benefit Admin Contracted [320251] | $93 | 335% |
| Yuzu Health Contracted [320521] | $93 | 335% |
| Auxiant Contracted [320462] | $93 | 335% |
| American Healthcare Alliance Contracted [320020] | $93 | 335% |
| Imagine 360 Contracted [320494] | $93 | 335% |
| Reflect Health Contracted [320492] | $93 | 335% |
| Healthlink Contracted [320179] | $93 | 335% |
| First Health Contracted [320128] | $99 | 357% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy, the gross charge at Mercy Hospital Pittsburg, Inc. is $116.00. While the facility offers a cash median price of $75.00, which is lower than the negotiated rates paid by most commercial payers, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs due to administrative fees and contract structures. The facility's cash rate is notably lower than the state average for this service, making it a potentially cost-effective option for patients with high-deductible plans or those who qualify for self-pay discounts. It is important to verify the specific "self-pay" or "prompt-pay" rates with the hospital before scheduling, as these upfront discounts can significantly reduce the final amount owed compared to standard insurance billing cycles.
When comparing this service to federal benchmarks, the Medicare amount for this procedure is set at $27.72. The facility's cash median of $75.00 represents a markup of approximately 2.7 times the Medicare rate, which is higher than the typical fair pricing range of 120% to 150% of Medicare. However, many commercial payers negotiate rates that exceed the cash price; for instance, Blue Cross Blue Shield plans may pay up to $70.00, while Aetna plans can reach $99.00. To ensure you are receiving the most favorable rate, patients should request an itemized bill to review specific CPT codes and avoid summary bills that may obscure individual charges. Additionally, if you have out-of-network services, the No Surprises Act may protect you from balance billing