Physical therapy (manual therapy)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $94
- Cash Discount Price: $69
- vs. Medicare Baseline: 3.39x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 339% of the Medicare baseline (a markup of 239%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Web Tpa [2115] | $94 | 339% |
| Blue Cross Blue Shield | $94 | 339% |
| Hooray Health [8000] | $94 | 339% |
| Lucent Health [6000] | $94 | 339% |
| Aetna | $94 | 339% |
| Oncology Patient Assistance Programs [2295] | $94 | 339% |
| Black Lung [6055] | $94 | 339% |
| Healthcare Highways [2210] | $94 | 339% |
| Department Of Corrections [1340] | $115 | 415% |
| National Association Of Letter Carriers [1695] | $133 | 480% |
| Healthpartners [1500] | $133 | 480% |
| Cigna | $133 | 480% |
| American Postal Workers Union [1070] | $133 | 480% |
| Humana | $136 | 491% |
| American Healthcare [1055] | $179 | 646% |
| Administrative Concepts [1005] | $179 | 646% |
| First Health [1375] | $179 | 646% |
| Multiplan [1680] | $179 | 646% |
| Coventry Healthcare [1320] | $189 | 682% |
| Ks Disability Determination [6090] | $230 | 830% |
Consumer Guidance & Cost Commentary
For the CPT code 97140 (Physical therapy manual therapy) at the University of Kansas Health System - St Francis Campus in Topeka, KS, the facility's negotiated rates range from $94 to $179, with a median negotiated payment of $94. This is notably lower than the facility's gross charge of $230, reflecting the contractual ceilings that protect in-network members. However, the cash price for this service is $69, which is significantly lower than both the negotiated rate and the Medicare benchmark of $27.72. While the facility is a voluntary non-profit acute care hospital, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $69, as paying out-of-pocket could result in immediate savings compared to the administrative overhead embedded in insurance payments.
When comparing pricing structures, it is important to note that the facility's cash median of $69 is substantially lower than the state and county averages often seen for similar services, where commercial rates can inflate due to multi-layered administrative costs. The data indicates a wide variance in allowed amounts across different payers, with some organizations like Web TPA and Blue Cross Blue Shield paying the minimum negotiated rate of $94, while others like American Healthcare pay up to $179. To optimize costs, patients should verify their specific plan's allowed amount before scheduling and explicitly request self-pay or prompt-pay discounts prior to check-in, as these upfront incentives can bypass the costly insurance billing cycle and reduce the final bill by 20% to 50%.