Physical therapy (manual therapy)
Facility: Ellsworth County Medical Center
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $70
- Cash Discount Price: $78
- vs. Medicare Baseline: 2.53x 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 253% of the Medicare baseline (a markup of 153%). 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 |
|---|---|---|
| Va Ccn-All Plans | $37 | 133% |
| Humana | $37 - $74 | 133% |
| Healthy Blue Mcr Adv | $37 | 133% |
| Triwest -All Plans | $37 | 133% |
| Blue Cross Blue Shield | $48 - $50 | 173% |
| UnitedHealthcare | $51 - $78 | 184% |
| First Health - All Plans | $70 | 253% |
| Aetna | $70 | 253% |
| Cigna | $74 | 267% |
| Coventry Mcaid-All Plans | $78 | 281% |
| Healthy Blue Mcaid- All Other Plans | $78 | 281% |
| Medicaid / KanCare | $78 | 281% |
| Providers Care-Wppa-All Plans | $117 | 422% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy, the cash median price at Ellsworth County Medical Center is $78.00. This cash rate is significantly higher than the state of Kansas average, which is $60.00. While the facility's negotiated rates with insurance payers range from $37 to $117, patients with high-deductible plans may find the cash price more affordable if their insurance negotiated rate exceeds $78.00. It is important to note that commercial rates often include administrative overhead, and fair pricing is typically defined as 120% to 150% of the Medicare amount of $27.72 for this service.
To ensure you are receiving the most accurate pricing, always request an itemized bill before paying, as summary bills can obscure individual charges and potential errors. If you choose to pay out-of-pocket, ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if settled upfront. Additionally, be aware that while the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, unexpected charges can still occur for out-of-network ancillary services like laboratory tests. Always verify your deductible status and compare the facility's rates against the Medicare benchmark to understand the true cost relative to the provider's base charges.