Physical therapy (manual therapy)
Facility: Centura St. Catherine-Dodge City
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $115
- Cash Discount Price: $70
- vs. Medicare Baseline: 4.15x 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 415% of the Medicare baseline (a markup of 315%). 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 |
|---|---|---|
| Kaiser | $28 | 101% |
| Medicare (plans) | $28 | 101% |
| Kansas Health | $28 | 101% |
| Aetna | $28 - $139 | 101% |
| Cigna | $28 | 101% |
| Blue Cross Blue Shield | $28 - $68 | 101% |
| Humana | $28 | 101% |
| Centura Employee Plan | $72 | 260% |
| UnitedHealthcare | $115 | 415% |
| Wpaa | $122 | 440% |
| Multiplan | $139 - $157 | 501% |
| Christian Health Aid | $139 | 501% |
| Health Partners Of Kansas | $157 | 566% |
Consumer Guidance & Cost Commentary
For this physical therapy service at Centura St. Catherine-Dodge City, the negotiated rates range from $28 to $157, with a median of $115. This is notably higher than the facility's cash price of $70, which is also lower than the state of Kansas average for this procedure. While commercial insurance plans like Aetna and Multiplan have negotiated rates between $28 and $157, patients with high-deductible plans may find paying the $70 cash price more cost-effective if their insurance allowed amount exceeds this figure. It is important to verify your specific plan's allowed amount before scheduling, as assuming in-network status guarantees the lowest price can lead to unexpected costs if the insurer's negotiated rate is significantly higher than the cash rate.
The facility's Medicare benchmark of $27.72 serves as the objective baseline for evaluating pricing, revealing that commercial negotiated rates often carry a substantial markup compared to the federal government's fixed reimbursement. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request a full itemized bill to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors. Additionally, patients should inquire about prompt-pay discounts before check-in, as paying the bill in full upfront can sometimes bypass administrative fees and reduce the total owed, though this must be done carefully to avoid voiding insurance coverage or triggering surprise billing disputes.