Physical therapy (manual therapy)
Facility: Phillips County Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $65
- Cash Discount Price: $57
- vs. Medicare Baseline: 2.34x 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 234% of the Medicare baseline (a markup of 134%). 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 |
|---|---|---|
| UnitedHealthcare | $56 - $70 | 202% |
| Blue Cross Blue Shield | $57 - $242 | 206% |
| Health Partners-All Plans | $65 - $70 | 234% |
| Medicaid / KanCare | $65 - $70 | 234% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy, Phillips County Hospital in Phillipsburg, KS, lists a cash median price of $57.00 and a median negotiated rate of $65.00. While the facility's cash price is lower than its negotiated rates, it is important to note that commercial insurance plans often pay significantly more than the cash price; for instance, Blue Cross Blue Shield's negotiated range extends up to $242, and UnitedHealthcare's range goes up to $70. This dynamic suggests that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $57.00 upfront could result in immediate savings compared to the higher amounts their insurance might negotiate and then require them to cover. Patients should verify their specific plan's deductible status before scheduling, as relying on insurance coverage without checking the accumulator balance can lead to unexpected financial responsibility.
When evaluating the cost against federal benchmarks, the Medicare amount for this service is $27.72, which serves as the objective baseline for pricing. The facility's cash price of $57.00 is approximately 2.3 times the Medicare rate, while the median negotiated rate of $65.00 represents a higher markup typical of commercial contracts. Although the data does not provide specific state or county average figures for comparison, the facility is a Critical Access Hospital with government-local ownership, which often influences pricing structures. To maximize potential savings, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid