Physical therapy (manual therapy)
Facility: Rawlins County Health Center
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $100
- Cash Discount Price: $98
- vs. Medicare Baseline: 3.61x 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 361% of the Medicare baseline (a markup of 261%). 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 | $50 | 180% |
| UnitedHealthcare | $100 | 361% |
Consumer Guidance & Cost Commentary
For this Physical therapy (manual therapy) service at Rawlins County Health Center in Atwood, Kansas, the cash price is $98.00, which is lower than the facility's negotiated rates of $100.00 and the maximum allowed amounts of $100.00 for both Blue Cross Blue Shield and UnitedHealthcare. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance rates often include administrative overhead that can make them higher than direct cash payments. If you have a high-deductible plan, paying the cash price of $98.00 upfront might result in lower out-of-pocket costs compared to your insurance's negotiated rate, especially if you have not yet met your deductible. We recommend contacting the hospital directly to confirm if they offer a "self-pay" or "prompt-pay" discount, which could further reduce the final amount owed.
To ensure you are receiving the most accurate pricing, it is important to request an itemized bill that breaks down the specific CPT code 97140 rather than accepting a summary invoice that may hide unbundled charges or services not rendered. The Medicare benchmark for this procedure is $27.72, and the facility's cash rate is approximately 3.6 times the Medicare amount, which is consistent with typical commercial pricing structures where rates often range from 200% to 300% of the Medicare baseline. If you receive a balance bill for the difference between the provider's full charge and your insurance allowed amount, you should dispute the bill with your insurer and request a review under the No Surprises Act, as federal protections generally prevent surprise