Physical therapy (manual therapy)
Facility: F W Huston Medical Center
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $83
- Cash Discount Price: $86
- vs. Medicare Baseline: 2.99x 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 299% of the Medicare baseline (a markup of 199%). 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% |
| Aetna | $81 | 292% |
| Humana | $85 | 307% |
| Cigna | $92 | 332% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy at F W Huston Medical Center in Winchester, KS, the facility's cash median rate is $86.00, while the median negotiated rate for in-network payers is $83.00. It is important to note that for patients with high-deductible plans, paying the cash price of $86.00 upfront can sometimes be more cost-effective than relying on insurance, as the negotiated rate of $83.00 may still exceed the patient's out-of-pocket responsibility before the deductible is met. Additionally, patients should verify with the hospital for potential "self-pay" or "prompt-pay" discounts, which could further reduce the final amount owed.
When evaluating the value of this service, it is crucial to compare rates against the Medicare benchmark rather than the facility's gross charge. The Medicare amount for this procedure is $27.72, and the facility's cash rate represents a significant markup above this federal baseline. While the data does not provide specific county or state average comparisons for this code, understanding that commercial negotiated rates often average 200% to 300% of Medicare rates helps contextualize the pricing. To ensure you are receiving fair pricing, always request an itemized bill to review specific CPT codes and avoid summary bills that may obscure individual charges, and consider disputing any errors in writing to protect against overcharging.