Physical therapy (manual therapy)
Facility: Great Plains Of Sabetha
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $69
- Cash Discount Price: $72
- vs. Medicare Baseline: 2.49x 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 249% of the Medicare baseline (a markup of 149%). 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 |
|---|---|---|
| Celtic Mcr Adv | $36 - $57 | 130% |
| Aetna | $36 - $111 | 130% |
| Celtic Comm Exchange-All Other Plans | $45 - $72 | 162% |
| Great West Healthcare-All Plans | $59 - $94 | 213% |
| UnitedHealthcare | $64 - $110 | 231% |
| Humana | $66 - $104 | 238% |
| Federated Mutual Ins-All Plans | $66 - $106 | 238% |
| Multiplan-Phcs-All Plans | $66 - $104 | 238% |
| Century/Wppa/Providers-All Plans | $66 - $104 | 238% |
| Cigna | $66 - $104 | 238% |
| Medicaid / KanCare | $69 - $110 | 249% |
| Blue Cross Blue Shield | $69 - $110 | 249% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy (manual therapy), the cash price at Great Plains Of Sabetha is $72.00, which matches the facility's median negotiated rate of $69.00. This cash price is notably lower than the state average for this service, offering a potential savings opportunity for patients with high-deductible plans or those without insurance. While commercial payers like Aetna and UnitedHealthcare negotiate rates ranging from $36 to $110, the cash rate of $72.00 remains competitive. Patients should verify if their specific plan has a deductible that would make the higher negotiated rate more expensive than paying the cash price upfront, as insurance processing often adds administrative costs that can inflate the final out-of-pocket expense.
To ensure you receive the most accurate pricing, it is recommended to request a self-pay or prompt-pay discount directly from the hospital before scheduling your visit. These discounts can reduce the bill by 20% to 50% by bypassing the costly claims processing cycle associated with insurance billing. If you do receive a bill from an out-of-network provider, the No Surprises Act may protect you from balance billing for emergency care or non-emergency services at in-network facilities, but you should dispute any unexpected charges in writing rather than paying immediately. Always ask for a full itemized bill to review specific CPT codes and avoid paying for services that were not rendered or that have been incorrectly bundled.