Physical therapy (manual therapy)
Facility: Kiowa County Memorial Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $80
- Cash Discount Price: $77
- vs. Medicare Baseline: 2.89x 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 289% of the Medicare baseline (a markup of 189%). 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 - $80 | 180% |
| UnitedHealthcare | $72 - $90 | 260% |
| Health Partners Of Ks-All Plans | $79 | 285% |
| Aetna | $80 | 289% |
| Medica Prime Mcare Cost-All Plans | $80 | 289% |
| Humana | $80 | 289% |
| Celtic Comml Exchange-All Other Plans | $80 | 289% |
| Medicaid / KanCare | $90 | 325% |
| Providrs Care/Wppa-All Plans | $135 | 487% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy, the gross charge at Kiowa County Memorial Hospital is $90.00. While the facility's cash median price of $77.00 is lower than the gross charge, it is important to note that commercial insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. In this case, the median negotiated rate across payers is $80.00, which is higher than the cash price. This dynamic suggests that patients with high-deductible plans or those who have met their out-of-pocket maximums might find paying the cash price of $77.00 more cost-effective than relying on insurance, which could result in a higher allowed amount.
When evaluating the cost relative to federal standards, the facility's gross charge of $90.00 represents a 2.9x markup compared to the Medicare amount of $27.72. This significant difference highlights why comparing rates to the Medicare benchmark is essential for understanding true value, rather than relying on the hospital's inflated list prices. Additionally, because this facility is a Critical Access Hospital in Greensburg, KS, patients should proactively contact the billing department before scheduling to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final balance. It is also advisable to request a full itemized bill to ensure no errors exist, as over 80% of hospital bills contain discrepancies that can be corrected through a formal audit.