Physical therapy (manual therapy)
Facility: Stevens County Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $62
- Cash Discount Price: $71
- vs. Medicare Baseline: 2.24x 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 224% of the Medicare baseline (a markup of 124%). 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 |
|---|---|---|
| Humana | $26 | 94% |
| Aetna | $27 - $71 | 97% |
| Blue Cross Blue Shield | $55 - $58 | 198% |
| First Health - All Plans | $64 | 231% |
| Wppa - All Plans | $68 | 245% |
| Medicaid / KanCare | $71 | 256% |
Consumer Guidance & Cost Commentary
For this physical therapy service at Stevens County Hospital in Hugoton, Kansas, the cash price is $71.00, which matches the facility's negotiated rate for Medicaid and the gross chargemaster. While the median amount paid by commercial insurers is $62.00, patients with high-deductible plans might find paying the full cash price of $71.00 more cost-effective than relying on insurance, as the negotiated rate often exceeds the cash price. It is important to note that while the facility is a Critical Access Hospital with a government-local ownership structure, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final bill by bypassing administrative processing costs.
The data indicates that this specific CPT code has a 2.2x markup compared to the Medicare benchmark of $27.72, highlighting the difference between the federal cost baseline and commercial pricing. Although the facility does not provide a direct comparison to state or county averages in this dataset, the variation in allowed amounts across payers—ranging from $26 for Humana to $71 for Medicaid—demonstrates how contract terms vary significantly. To avoid unexpected costs, consumers should request a full itemized bill to verify that no services were unbundled or double-charged, as over 80% of hospital bills contain errors. If a balance bill arises from an out-of-network situation, patients should utilize the No Surprises Act to dispute the charge rather than paying immediately out of fear of credit damage.