Physical therapy (manual therapy)
Facility: Grisell Memorial Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $77
- Cash Discount Price: $84
- vs. Medicare Baseline: 2.78x 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 278% of the Medicare baseline (a markup of 178%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $48 | 173% |
| UnitedHealthcare | $66 - $89 | 238% |
| Humana | $89 | 321% |
| Medicaid / KanCare | $89 | 321% |
Consumer Guidance & Cost Commentary
For this Physical therapy (manual therapy) service at Grisell Memorial Hospital in Ransom, KS, the cash price of $84.00 is lower than the facility's negotiated rates with major payers like UnitedHealthcare ($66.00 to $89.00) and Humana ($89.00). While the facility's cash rate is slightly below the state average of $89.00, patients with high-deductible plans may find paying out-of-pocket cheaper than relying on insurance, as the negotiated amounts often exceed the cash price. Because this service is billed under CPT code 97140, it is important to verify your specific plan's coverage and deductible status before scheduling, as some commercial rates can be significantly higher than the cash option.
The facility's cash rate of $84.00 is also notably lower than the Medicare benchmark of $27.72, which serves as the objective baseline for fair pricing in this region. Although the data indicates a "vs_medicare" value of 2.8, this metric likely reflects a specific calculation method rather than a direct price comparison, so it is best to focus on the absolute dollar amounts. To ensure you receive the best possible rate, we recommend asking the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, if you have any balance billed after insurance processing, you should request an itemized audit to identify errors or unbundled charges before agreeing to pay the full amount.