Physical therapy (manual therapy)
Facility: Osborne County Memorial Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $81
- Cash Discount Price: $76
- vs. Medicare Baseline: 2.92x 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 292% of the Medicare baseline (a markup of 192%). 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 | $67 - $68 | 242% |
| Health Partners Of Kansas | $76 - $77 | 274% |
| Wppa | $84 - $85 | 303% |
| Blue Cross Blue Shield | $86 - $87 | 310% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy at Osborne County Memorial Hospital, the cash price is $76.00, which is lower than the facility's gross charge of $89.00. While the hospital is a Critical Access Hospital in Osborne, Kansas, and owned by the local government, the data does not provide specific county or state average figures for this procedure to compare against. The negotiated rates for in-network payers range from $67.00 to $87.00, with UnitedHealthcare and Health Partners of Kansas offering the lowest contracted amounts at $67.00 and $76.00 respectively. Because these negotiated rates often exceed the cash price, patients with high-deductible plans may find it financially advantageous to pay the cash rate of $76.00 directly, provided they have not met their out-of-pocket maximum.
The Medicare benchmark for this service is $27.72, which serves as a baseline to evaluate the facility's pricing structure. The hospital's cash rate is approximately 2.9 times the Medicare amount, reflecting the typical administrative and clinical costs associated with outpatient therapy. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details before scheduling. To ensure the lowest possible cost, we recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill if payment is made in full upfront.