Physical therapy (manual therapy)
Facility: Kiowa District Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $94
- Cash Discount Price: $79
- vs. Medicare Baseline: 3.39x 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 339% of the Medicare baseline (a markup of 239%). 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 |
|---|---|---|
| Tricare | $39 | 141% |
| Healthchoice-All Plans | $42 | 152% |
| Blue Cross Blue Shield | $50 | 180% |
| UnitedHealthcare | $79 - $99 | 285% |
| Health Partners Of Ks-All Plans | $87 | 314% |
| Humana | $89 | 321% |
| Gbs Insurance - All Plans | $93 | 335% |
| Multiplan-All Plans | $93 | 335% |
| Triwest-All Plans | $94 | 339% |
| Aetna | $94 | 339% |
| Medicare (plans) | $94 | 339% |
| Medicaid / KanCare | $99 | 357% |
| Providers Care (Wppa)-All Plans | $148 | 534% |
| Liberty Healthshare-All Plans | $160 | 577% |
Consumer Guidance & Cost Commentary
For this Physical therapy (manual therapy) service at Kiowa District Hospital, the cash price of $79.00 is notably lower than the median negotiated rate of $93.00 paid by most commercial insurers, including UnitedHealthcare and Humana. While the facility's cash rate is also lower than the state average of $99.00, patients with high-deductible plans may find that paying the cash price upfront is more cost-effective than relying on insurance, which often results in higher out-of-pocket costs due to deductibles and co-pays. Because the facility is a Critical Access Hospital in Kiowa, KS, and is owned by a Government Hospital District, it is important to verify your specific plan's allowed amount before scheduling, as in-network rates vary significantly even within the same facility.
To minimize potential costs, we recommend requesting a "prompt-pay" discount from the billing department if you choose to pay cash directly, as hospitals often offer 20% to 50% reductions for upfront payments to bypass administrative processing fees. Additionally, since the Medicare benchmark for this service is $27.72, the commercial negotiated rates reflect a significant markup compared to the federal baseline, which serves as the objective standard for fair pricing. If you receive a bill after using insurance, always request a full itemized statement to review every CPT code and ensure no services were double-billed or unbundled, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.