Physical therapy (manual therapy)
Facility: Pratt Regional Medical Center
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $108
- Cash Discount Price: $89
- vs. Medicare Baseline: 3.90x 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 390% of the Medicare baseline (a markup of 290%). 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 |
|---|---|---|
| Celtic Insurance Company | $26 | 94% |
| Healthy Blue | $26 | 94% |
| UnitedHealthcare | $28 - $130 | 101% |
| Christian Health Aid | $95 | 343% |
| Health Partners Of Kansas | $107 - $108 | 386% |
| Aetna | $113 - $114 | 408% |
| Choicecare | $126 - $127 | 455% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy at Pratt Regional Medical Center in Pratt, Kansas, the cash price is $89.00, which is significantly lower than the facility's gross charge of $127.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $26 to $130, the cash price offers a distinct advantage for patients with high-deductible plans or those without insurance, as it avoids the administrative markup often found in commercial contracts. It is important to note that while the facility's cash rate is competitive, patients should verify their specific plan's deductible status before assuming insurance will result in lower out-of-pocket costs, as some negotiated rates may exceed the cash price depending on the payer's contract terms.
The facility's pricing structure is evaluated against federal benchmarks, with the Medicare rate for this service set at $27.72. The cash price of $89.00 represents a markup of 3.9 times the Medicare amount, which falls within the typical range for commercial pricing where negotiated rates often average between 200% and 300% of the Medicare baseline. To minimize costs, patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill. Additionally, if a patient receives an itemized bill, they should request a full line-by-line audit to ensure no errors, unbundled codes, or services not rendered are included, as over 80% of hospital bills contain discrepancies that can be corrected through formal written disputes.