Physical therapy (manual therapy)
Facility: Stormont Vail Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $55
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.98x 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 |
|---|---|---|
| Ambetter / Centene | $23 | 83% |
| UnitedHealthcare | $23 | 83% |
| Blue Cross Blue Shield | $23 - $78 | 83% |
Consumer Guidance & Cost Commentary
For CPT code 97140, representing physical therapy with manual therapy at Stormont Vail Hospital in Topeka, KS, the facility's negotiated rates range from $23 to $78 depending on the insurance plan, with a median negotiated amount of $55.00. This facility is located in a rural area of Kansas, where the state average for this service is $27.72, the same as the Medicare benchmark. While the hospital's negotiated rates are higher than the state average, patients with high-deductible plans might find that paying the cash price directly could be more cost-effective, as cash payments often bypass the administrative overhead and markup associated with insurance billing cycles. It is important to note that the facility offers a voluntary non-profit structure, which may influence their pricing strategy compared to for-profit competitors.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is still crucial to verify your specific plan's allowed amount before scheduling. If you choose to pay out-of-pocket, you should explicitly ask the billing department for a "self-pay" or "prompt-pay" discount, which can significantly reduce the total cost by bypassing the claims processing fees that inflate commercial rates. Additionally, if you receive a bill, always request a full itemized statement to review every line item for potential errors, such as unbundled codes or services not rendered, as over 80% of hospital bills contain discrepancies that can be corrected through a formal written audit dispute.