Physical therapy (manual therapy)
Facility: Graham County Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $49
- Cash Discount Price: $66
- vs. Medicare Baseline: 1.77x 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 |
|---|---|---|
| UnitedHealthcare | $36 - $76 | 130% |
| Medicaid / KanCare | $36 | 130% |
| Medicare (plans) | $39 - $60 | 141% |
| Celtic Commercial-All Other Plans | $43 - $66 | 155% |
| Wppa (Providers Care)-All Plans | $49 - $76 | 177% |
| Blue Cross Blue Shield | $50 | 180% |
Consumer Guidance & Cost Commentary
For Physical therapy (manual therapy) at Graham County Hospital in Hill City, KS, the cash price of $66.00 is significantly lower than the facility's negotiated rates with major payers like UnitedHealthcare and Wppa (Providers Care), which range from $49.00 to $76.00. This price difference highlights the potential savings for patients with high-deductible plans who may pay less out-of-pocket by paying cash directly, as the insurance negotiated rates often exceed the cash price. While the facility is a Critical Access Hospital with government-local ownership, patients should verify their specific plan's allowed amount before scheduling, as in-network rates can vary widely between carriers.
The facility's cash rate of $66.00 aligns exactly with the cash median, but it is important to note that Medicare's benchmark rate for this service is $27.72, meaning commercial rates are substantially higher than the federal baseline. To ensure you are not overcharged, always request an itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered. Additionally, ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims processing.