Physical therapy (manual therapy)
Facility: Lincoln County Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $58
- Cash Discount Price: $73
- vs. Medicare Baseline: 2.09x 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 209% of the Medicare baseline (a markup of 109%). 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 | $58 | 209% |
Consumer Guidance & Cost Commentary
For CPT code 97140, Physical therapy (manual therapy), Lincoln County Hospital in Lincoln, KS, lists a cash median price of $73.00 and a median negotiated rate of $58.00. This cash price is notably lower than the facility's gross charge of $81.00, which is common when patients pay directly. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying the cash price of $73.00 more affordable than the negotiated rate of $58.00 if their insurance deductible has not yet been met, as the negotiated rate often includes administrative overheads that cash payments bypass. It is always advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can further reduce the final amount owed.
The pricing for this service is benchmarked against federal standards, where the Medicare amount is set at $27.72. The facility's cash rate of $73.00 represents a significant markup over the Medicare baseline, illustrating how commercial pricing structures differ from the government's cost-based reimbursement. Since the data indicates a single payer, Blue Cross Blue Shield, with a negotiated rate of $58.00, patients should verify their specific plan details to understand exactly how much of the $58.00 rate will be covered versus what they might owe. If you receive a bill for this service, you should request an itemized statement to ensure no errors or unbundled charges exist, as over 80% of hospital bills contain discrepancies that can be resolved through a formal