Physical therapy (manual therapy)
Facility: Wichita County Health Center
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $63
- Cash Discount Price: $56
- vs. Medicare Baseline: 2.27x 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 227% of the Medicare baseline (a markup of 127%). 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 |
|---|---|---|
| Medicaid / KanCare | $50 - $65 | 180% |
| UnitedHealthcare | $60 - $79 | 216% |
Consumer Guidance & Cost Commentary
For this physical therapy session at Wichita County Health Center in Leoti, Kansas, the cash price of $56.00 is notably lower than the facility's negotiated rates with major payers like Medicaid/KanCare ($50–$65) and UnitedHealthcare ($60–$79). Because commercial insurance contracts often include administrative overheads that inflate the final bill, paying cash upfront can sometimes result in significant savings compared to what your insurance plan would allow. If you have a high-deductible plan, it may be financially advantageous to pay the cash price directly, provided you confirm with the hospital that they will not submit an insurance claim that could void the discount.
To maximize your payment, you should explicitly request a "prompt-pay" discount before scheduling your visit, as facilities often offer 20% to 50% reductions for upfront payments that bypass costly claims processing. Additionally, always ask for an itemized bill rather than a summary invoice to ensure no services were double-billed or unbundled, as over 80% of medical bills contain errors. While the facility's negotiated rates are higher than the cash price, the Medicare benchmark of $27.72 serves as a baseline for fair pricing; the commercial rates reflect the administrative costs of insurance billing, which is why the cash option remains the most transparent and potentially economical choice for patients.