Physical therapy (manual therapy)
Facility: Providence Medical Center
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $28
- Cash Discount Price: $26
- vs. Medicare Baseline: 1.01x 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 |
|---|---|---|
| Aetna | $21 - $39 | 76% |
| Medicaid / KanCare | $22 | 79% |
| UnitedHealthcare | $22 - $137 | 79% |
| Celtic | $23 - $42 | 83% |
| Healthy Blue | $23 - $28 | 83% |
| Midland Care Connection | $26 | 94% |
| Blue Cross Blue Shield | $26 - $62 | 94% |
| Cigna | $26 | 94% |
| Tricare | $26 | 94% |
| Medicare (plans) | $26 | 94% |
| Kansas Superior Select | $28 | 101% |
| Corizon | $34 | 123% |
| Employer Direct Healthcare | $37 | 133% |
| Well Path Prison | $37 | 133% |
| Centurion | $39 | 141% |
| Naphcare | $41 | 148% |
Consumer Guidance & Cost Commentary
For this physical therapy service at Providence Medical Center in Kansas City, KS, the facility's cash median rate is $26.00, which is significantly lower than the state average of $426.00. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates ranging from $21 to $137, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket if they qualify for a self-pay or prompt-pay discount. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still verify their specific plan details and ask the hospital directly about available cash discounts before scheduling to avoid unexpected costs.
The facility's Medicare benchmark rate of $27.72 serves as a reliable baseline for evaluating pricing fairness, as it reflects the true cost of care rather than inflated chargemaster lists. Although the facility is a voluntary non-profit church-owned acute care hospital with a 3-star rating, the wide variation in negotiated rates across different payers—such as the $21 minimum for Aetna versus the $137 maximum for UnitedHealthcare—highlights the importance of checking your specific deductible status and allowed amount before treatment. To ensure you are not overcharged, request a full itemized CPT-coded bill to review every line item for errors or unbundled charges, and do not accept summary bills as your final invoice without a detailed audit.