Physical therapy (manual therapy)
Facility: Kansas City Orthopaedic Institute
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $95
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.43x 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 343% of the Medicare baseline (a markup of 243%). 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 |
|---|---|---|
| Aetna | $34 | 123% |
| UnitedHealthcare | $34 - $124 | 123% |
| Cigna | $35 - $125 | 126% |
| Blue Cross Blue Shield | $72 - $107 | 260% |
| Medica | $172 | 620% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy, the Kansas City Orthopaedic Institute in Leawood, KS, has a negotiated payment range of $34 to $172 across five payers, with a median negotiated rate of $95.00. This facility, an acute care hospital owned by physicians, charges a gross list price of $126.00. While the facility's negotiated rates vary significantly by insurer, it is important to note that cash-pay options are not listed for this service. Patients with high-deductible plans should be aware that paying out-of-pocket might be more cost-effective if the insurance company's allowed amount exceeds the cash price, though no cash median was reported for this specific code.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, you should still verify your specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid upfront. Always compare the facility's rates against the Medicare benchmark of $27.72; commercial negotiated rates often exceed this baseline due to administrative costs and contract dynamics, so focusing on the Medicare amount provides a more accurate view of the true cost of care than the facility's gross chargemaster list.