Physical therapy (manual therapy)
Facility: Mcpherson Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $83
- Cash Discount Price: $81
- vs. Medicare Baseline: 2.99x 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 299% of the Medicare baseline (a markup of 199%). 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 |
|---|---|---|
| Tricare | $23 | 83% |
| Humana | $26 | 94% |
| Healthy Blue Mcr Adv | $26 | 94% |
| Va Ccn - All Plans | $26 | 94% |
| Wellcare Mcr Adv - All Plans | $26 | 94% |
| UnitedHealthcare | $26 - $109 | 94% |
| Blue Cross Blue Shield | $26 | 94% |
| Ambetter / Centene | $30 | 108% |
| Wppa - All Plans | $76 | 274% |
| Central Plains - All Plans | $82 | 296% |
| Medical Associates - All Plans | $82 | 296% |
| Christian Health Aid - All Plans | $87 | 314% |
| Aetna | $90 - $109 | 325% |
| Multiplan - All Plans | $98 | 354% |
| First Health - All Plans | $104 | 375% |
| Cigna | $104 | 375% |
| Health Partners - All Plans | $104 | 375% |
| Medicaid / KanCare | $109 | 393% |
| Health Blue Mcaid - All Other Plans | $111 | 400% |
Consumer Guidance & Cost Commentary
For CPT code 97140, Physical therapy (manual therapy), McPherson Hospital in Mcpherson, KS lists a gross charge of $109.00. This rate is significantly higher than the state average, which sits at $83.00 for the median negotiated amount. While the facility offers a cash price of $81.00, this is still above the state median. Patients with high-deductible plans should consider that paying the cash price of $81.00 upfront might be more cost-effective than using insurance, as the negotiated rates for many payers, such as UnitedHealthcare and Aetna, can reach up to $109.00. To minimize costs, patients should verify their specific plan's allowed amount before scheduling and ask the hospital directly about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid in full.
The facility's pricing is also evaluated against the Medicare benchmark, which is $27.72 for this service. The commercial negotiated rates at McPherson Hospital average 3.0 times the Medicare amount, reflecting the typical markup found in commercial contracts. Because the No Surprises Act prohibits balance billing for out-of-network providers at in-network facilities, patients can expect the facility to adhere to the negotiated rates listed for their specific insurance carrier rather than charging the full chargemaster. If a patient receives an itemized bill that appears higher than the negotiated rate, they should request a formal itemized audit to identify any unbundled codes or services not rendered, ensuring they are not paying for unnecessary charges.