Physical therapy (manual therapy)
Facility: Wilson Medical Center
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $102
- Cash Discount Price: $95
- vs. Medicare Baseline: 3.68x 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 368% of the Medicare baseline (a markup of 268%). 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 - $127 | 180% |
| Ambetter / Centene | $67 - $127 | 242% |
| Aetna | $67 - $127 | 242% |
| Tricare | $67 | 242% |
| UnitedHealthcare | $67 - $118 | 242% |
| Humana | $67 | 242% |
| Cigna | $102 | 368% |
| Health Partners-All Plans | $117 | 422% |
| Mulitplan-All Plans | $117 | 422% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy, Wilson Medical Center in Neodesha, KS, lists a gross charge of $127.00. This facility, a Critical Access Hospital owned by the local government, has negotiated rates ranging from $67.00 to $127.00 across nine different payers, with the median negotiated amount being $102.00. While the cash price is set at $95.00, which is lower than the median negotiated rate, patients should be aware that paying cash upfront may not always be the most cost-effective option if their insurance plan has a high deductible or if the specific payer's allowed amount exceeds the cash price. It is advisable to contact the billing department directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling services.
When evaluating the cost of this service, it is important to compare rates against the Medicare benchmark rather than the facility's gross charges. The Medicare amount for this procedure is $27.72, and the data indicates a comparison factor of 3.7 relative to Medicare. Commercial rates often include administrative overhead and contract markups that can significantly inflate the price compared to the federal baseline. To ensure you are not overpaying, request an itemized bill that breaks down the specific CPT codes and unit costs, as summary bills can obscure individual charges. If you receive a bill that appears higher than expected, you have the right to request a formal audit to identify any errors, unbundled codes, or services not rendered, which is the most effective way to reduce medical debt.