Physical therapy (manual therapy)
Facility: Stafford County Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $75
- Cash Discount Price: $75
- vs. Medicare Baseline: 2.71x 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 271% of the Medicare baseline (a markup of 171%). 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 |
|---|---|---|
| Health Partners-All Plans | $71 | 256% |
| Humana | $75 | 271% |
| Medica Mcr- All Plans | $75 | 271% |
| Va Ccn-All Plans | $75 | 271% |
| UnitedHealthcare | $75 | 271% |
Consumer Guidance & Cost Commentary
For CPT code 97140, representing physical therapy with manual therapy, the cash and negotiated rates at Stafford County Hospital are both $75.00. This price is consistent across all five payers listed, including Health Partners, Humana, Medica, and UnitedHealthcare, with no variation in allowed amounts. The facility, a Critical Access Hospital in Stafford, KS, charges the same amount as its cash median and negotiated median. While the data does not provide specific state or county average figures for comparison, patients should note that cash payments can sometimes be more cost-effective than insurance claims if the negotiated rate exceeds the cash price, which is not the case here as both rates are identical.
The Medicare benchmark for this service is $27.72, indicating that the facility's rates are significantly higher than the federal baseline. Under the No Surprises Act, patients are protected from balance billing for out-of-network providers at in-network facilities, though they should still verify their specific plan details before scheduling. To potentially lower costs, patients should ask the hospital directly about self-pay or prompt-pay discounts, which can range from 20% to 50% off the billed amount when paid in full upfront. Additionally, if a detailed bill is received, requesting an itemized audit is recommended to ensure no errors, unbundled codes, or services not rendered have inflated the total, as over 80% of hospital bills contain such discrepancies.