Physical therapy (manual therapy)
Facility: Wamego Health Center
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $24
- Cash Discount Price: $48
- vs. Medicare Baseline: 0.87x 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 | $22 | 79% |
| Aetna | $23 | 83% |
| Medicaid / KanCare | $23 - $24 | 83% |
| Providrs Care | $33 | 119% |
| Blue Cross Blue Shield | $76 - $80 | 274% |
Consumer Guidance & Cost Commentary
For the CPT code 97140 (Physical therapy manual therapy) at Wamego Health Center in Wamego, KS, the facility's cash median rate is $48.00, which is significantly higher than the state average of $27.72. While commercial insurance plans like UnitedHealthcare and Aetna negotiate rates between $22 and $24, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that commercial negotiated rates typically include administrative overhead and contract premiums, often resulting in prices 200% to 300% higher than the Medicare benchmark of $27.72 for this service.
Patients should proactively ask the facility about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can sometimes reduce the bill by 20% to 50% and bypass costly insurance billing cycles. Since the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, verifying the specific allowed amount for your insurance plan is crucial, as in-network rates vary widely even within the same state. If you receive a bill after using insurance, request a detailed itemized statement to ensure no errors exist, as over 80% of hospital bills contain discrepancies that can be corrected through a formal audit.