Physical therapy (manual therapy)
Facility: Stanton County Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $110
- Cash Discount Price: $116
- vs. Medicare Baseline: 3.97x 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 397% of the Medicare baseline (a markup of 297%). 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 | $55 - $110 | 198% |
| Healthy Blue Mcr Adv - All Other Plans | $113 | 408% |
| Healthy Blue Mcaid | $116 | 418% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy at Stanton County Hospital in Johnson, KS, the cash price is $116.00, which matches the facility's negotiated rate for Healthy Blue Mcaid. This cash price is notably higher than the state average for this service, which is $111.00. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find that paying the cash price directly is more cost-effective than using insurance, as the negotiated rates for some payers, such as Blue Cross Blue Shield, can exceed the cash amount. To secure the lowest possible cost, patients should explicitly request self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative claim processing fees.
The facility's allowed amount for this service is $116.00, which is higher than the national median paid amount of $111.00. It is important to note that the Medicare benchmark for this code is $27.72, indicating that the commercial rates charged here are substantially higher than the federal baseline, a common practice in the healthcare system. If you receive a bill that includes charges for services not rendered, unbundled components, or items that were cancelled, you should request a full itemized audit before paying. Additionally, under the No Surprises Act, you are protected from balance billing for out-of-network services at in-network facilities, so you should dispute any unexpected bills and avoid signing consent waivers that waive these rights. Always verify your deductible status and compare in-network allowed amounts to ensure you are not paying more than