Physical therapy (manual therapy)
Facility: Ellinwood District Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $51
- Cash Discount Price: $62
- vs. Medicare Baseline: 1.84x 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 |
|---|---|---|
| Cigna | $49 - $52 | 177% |
| Humana | $49 - $52 | 177% |
| UnitedHealthcare | $49 - $52 | 177% |
| Blue Cross Blue Shield | $49 - $52 | 177% |
| Aetna | $49 - $52 | 177% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy, the gross charge at Ellinwood District Hospital in Ellinwood, KS is $73.00. This facility is a Critical Access Hospital owned by a Government Hospital District. While the Medicare benchmark for this service is $27.72, the median negotiated rate paid by commercial payers like Cigna, Humana, and UnitedHealthcare is $51.00. This negotiated amount is 1.8 times the Medicare rate. It is important to note that while insurance contracts set a ceiling on what payers will reimburse, these rates often exceed the cash price. For patients with high-deductible plans, paying the cash price of $62.00 directly could result in lower out-of-pocket costs if their insurance deductible has not yet been met, as the negotiated rate of $51.00 may still be higher than the cash amount once deductibles are factored in.
Patients should be aware that the facility's cash price of $62.00 is significantly lower than the typical negotiated rates charged by insurance companies, which include administrative overhead and contract management costs. To potentially reduce costs further, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can offer fee reductions for upfront payments. Additionally, since over 80% of hospital bills often contain errors such as unbundled codes or services not rendered, consumers should request a detailed, itemized bill before agreeing to pay. If a balance bill arises from an out-of-network provider, the No Surprises Act may protect patients from paying the difference between the provider's full