Physical therapy (manual therapy)
Facility: Hodgeman County Health Center
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $72
- Cash Discount Price: $82
- vs. Medicare Baseline: 2.60x 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 260% of the Medicare baseline (a markup of 160%). 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 | $48 - $50 | 173% |
| Humana | $65 | 234% |
| UnitedHealthcare | $65 - $97 | 234% |
| Triwest - All Plans | $65 | 234% |
| Medicaid / KanCare | $65 - $102 | 234% |
| Aetna | $82 | 296% |
| First Health - All Plans | $92 | 332% |
| Wppa (Provdrscare) - All Plans | $97 | 350% |
| Health Partners - All Plans | $97 | 350% |
Consumer Guidance & Cost Commentary
For the Physical therapy (manual therapy) service at Hodgeman County Health Center in Jetmore, Kansas, the cash median price is $82.00, which aligns exactly with the negotiated rate for Medicaid/KanCare and is lower than the cash median for Aetna ($82.00) and First Health ($92.00). While the facility's cash price is competitive, it is important to note that commercial insurance plans often negotiate rates higher than the cash price due to administrative costs and contract structures; for instance, UnitedHealthcare's range spans from $65 to $97, and UnitedHealthcare's high end ($97) matches the cash price. Patients with high-deductible plans may find paying the cash price of $82.00 more cost-effective if their insurance negotiated rate exceeds this amount, as they would avoid out-of-pocket costs until their deductible is met.
The facility's negotiated rate of $72.00 is lower than the cash median but still represents a markup relative to the Medicare benchmark of $27.72, which serves as the federal baseline for true cost. In the broader context of pricing, the facility's cash rate is significantly lower than the gross charge of $102.00, offering potential savings compared to the full list price. To ensure you receive the best possible rate, we recommend requesting an itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected. Additionally, ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final amount by 20% to