Physical therapy (manual therapy)
Facility: St Luke Hospital & Living Center
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $43
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.55x 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.
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 |
|---|---|---|
| Kansas Department Of Health And Environment | $43 | 155% |
| Bluestem Pace | $43 | 155% |
| Va Ccn | $43 | 155% |
| Humana | $43 | 155% |
| UnitedHealthcare | $43 | 155% |
| Blue Cross Blue Shield | $43 | 155% |
| Ambetter / Centene | $44 | 159% |
Consumer Guidance & Cost Commentary
For CPT code 97140, representing physical therapy with manual therapy, St Luke Hospital & Living Center in Marion, KS, has a gross charge of $85.00. The facility's negotiated rates for this service are consistently $43.00 across seven major payers, including Kansas Department Of Health And Environment, Humana, and UnitedHealthcare. This negotiated amount is significantly lower than the facility's gross charge, reflecting the contractual agreements that cap what insurers pay. While the facility is a Critical Access Hospital owned by a Government Hospital District, the data does not provide specific cash or median paid values for this code, so patients should verify their specific plan benefits directly with the hospital before scheduling.
The facility's pricing structure is notably higher than the Medicare benchmark, with a ratio of 1.6 times the Medicare amount of $27.72. This indicates that the commercial negotiated rate of $43.00 represents a markup relative to the federal baseline. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly could be more cost-effective than relying on insurance, as the negotiated rate often exceeds the cash price. However, since cash and median paid data are not available in this report, it is crucial to contact the billing department to confirm if a self-pay or prompt-pay discount is available, which could further reduce the final cost.