Physical therapy (manual therapy)
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $62
- Cash Discount Price: $73
- vs. Medicare Baseline: 2.24x 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 224% of the Medicare baseline (a markup of 124%). 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 |
|---|---|---|
| First Health Contracted [320128] | $19 | 69% |
| Aetna | $19 - $25 | 69% |
| Blue Cross Blue Shield | $22 - $38 | 79% |
| Medicaid / KanCare | $22 - $25 | 79% |
| Humana | $24 - $26 | 87% |
| UnitedHealthcare | $24 - $104 | 87% |
| Pace Of The Ozarks Contracted [320518] | $25 | 90% |
| Cigna | $25 - $86 | 90% |
| Cherokee Nation Health Serv Contracted [320066] | $25 | 90% |
| Globalhealth Contracted [320145] | $25 | 90% |
| Cross Timbers Hospice [20098] | $25 | 90% |
| Medical Associates Health Contracted [320444] | $25 | 90% |
| Medicare (plans) | $25 | 90% |
| Qual Choice Contracted [320325] | $25 | 90% |
| Halo Hcr Inc Hospice Contracted [320432] | $25 | 90% |
| Tricare | $25 | 90% |
| Centivo Contracted [320505] | $25 | 90% |
| Kindful Hospice Contracted [320434] | $25 | 90% |
| Elara Caring Aspire Hospice [20433] | $25 | 90% |
| Kindful Hospice [20434] | $25 | 90% |
| Mercy Mgd Behavioral Health Contracted [320259] | $25 | 90% |
| Halo Hcr Inc Hospice [20432] | $25 | 90% |
| Mercy Hospice Okc [20252] | $25 | 90% |
| Dept Of Veteran Affairs Contracted [320106] | $26 | 94% |
| Provider Partners Health Plans Contracted [320450] | $27 | 97% |
| Medica Contracted [320239] | $41 | 148% |
| Providrs Care Network Contracted [320484] | $49 | 177% |
| Point C Contracted [320238] | $56 - $84 | 202% |
| Show-Me Health Administrators Contracted [320483] | $67 | 242% |
| Mercy Benefit Admin Contracted [320251] | $67 - $78 | 242% |
| American Healthcare Alliance Contracted [320020] | $78 | 281% |
| Edison Health Solutions Contracted [320502] | $78 | 281% |
| Ebms Contracted [320493] | $78 | 281% |
| Yuzu Health Contracted [320521] | $78 | 281% |
| Imagine 360 Contracted [320494] | $78 | 281% |
| Aither Health Contracted [320449] | $78 | 281% |
| Auxiant Contracted [320462] | $78 - $84 | 281% |
| Reflect Health Contracted [320492] | $78 | 281% |
| Insurance System Inc Contracted [320465] | $84 | 303% |
| Health Systems Inc Contracted [320174] | $84 | 303% |
| Preferred Health Plan Contracted [320522] | $84 | 303% |
| Healthlink Contracted [320179] | $84 | 303% |
| Healthscope Contracted [320182] | $84 | 303% |
| Federal Medical Center Contracted [320127] | $84 | 303% |
| United Medical Resources Contracted [320454] | $84 - $102 | 303% |
| Benefit Management Contracted [320052] | $84 | 303% |
| Compcare Of The Ozarks Contracted [320437] | $88 | 317% |
| Workers Comp [20426] | $90 | 325% |
| Private Health Care Systems Contracted [320320] | $104 | 375% |
| Multiplan [20270] | $106 | 382% |
| Multiplan Contracted [320270] | $106 | 382% |
Consumer Guidance & Cost Commentary
For the Physical therapy (manual therapy) service (CPT 97140), the cash price at Mercy Specialty Hospital Southeast Kansas is $73.00, which is significantly lower than the facility's negotiated rates. While the median negotiated rate across payers is $62.00, the cash price remains the most transparent baseline for patients. It is important to note that for individuals with high-deductible plans, paying the cash price of $73.00 upfront may be more cost-effective than relying on insurance, as commercial negotiated rates often exceed the cash price due to administrative overhead and contract structures. Patients should verify their specific plan's deductible status before scheduling, as paying out-of-pocket can bypass the waiting period required to meet insurance thresholds.
To ensure you are receiving fair value, it is recommended to request an itemized billing audit before finalizing payment, as summary bills often obscure individual code costs and potential errors. When comparing this facility's pricing to regional standards, the cash rate of $73.00 is notably higher than the state-wide cash median of $23.00, though it remains well below the gross charge of $112.00. Additionally, the facility's negotiated rate is approximately 220% of the Medicare benchmark of $27.72, which aligns with typical commercial pricing markups. If you are self-paying, ask the billing department about prompt-pay discounts, which can reduce the total amount owed by 20% to 50% if settled within 30 days.