Physical therapy (manual therapy)
Facility: Sheridan County Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $80
- Cash Discount Price: $100
- vs. Medicare Baseline: 2.89x 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 289% of the Medicare baseline (a markup of 189%). 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 Insurance | $60 | 216% |
| Blue Cross Blue Shield | $80 | 289% |
| UnitedHealthcare | $95 | 343% |
Consumer Guidance & Cost Commentary
For this Physical therapy (manual therapy) service at Sheridan County Hospital in Hoxie, KS, the cash price is $100.00, which matches the facility's negotiated rate of $80.00 and the median cash price reported for the region. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance rates for this procedure can vary significantly. For instance, UnitedHealthcare's negotiated rate is listed at $95.00, whereas Celtic Insurance and Blue Cross Blue Shield both pay $60.00 and $80.00 respectively. Because cash-pay rates can sometimes be lower than what insurance companies negotiate, patients with high-deductible plans may find it financially advantageous to pay the full $100.00 directly rather than relying on insurance coverage, especially if their out-of-pocket costs would exceed the cash price.
When comparing this service to broader benchmarks, the facility's cash rate of $100.00 is notably higher than the Medicare benchmark of $27.72, reflecting a markup common in commercial healthcare pricing. However, the median negotiated rate of $80.00 suggests that commercial payers are paying less than the full cash price, which is typical for in-network arrangements. To ensure you are receiving the best possible rate, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed. Additionally, if you receive a bill from an out-of-network provider at this facility, you have the right to dispute balance billing under the No Surprises Act, and you should always request a detailed, item