Physical therapy (manual therapy)
Facility: Scott County Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $110
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.97x 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 397% of the Medicare baseline (a markup of 297%). 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 | $22 - $116 | 79% |
| Humana | $51 | 184% |
| Blue Cross Blue Shield | $58 | 209% |
| Wppa | $73 - $1,200 | 263% |
| Aetna | $110 | 397% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy, Scott County Hospital has a gross charge of $122.00. This amount is significantly higher than the state average, which is 400% of the Medicare benchmark rate of $27.72. While commercial payers like UnitedHealthcare and Humana have negotiated rates ranging from $22 to $116, these figures often exceed the cash price. For patients with high-deductible plans, paying the cash price directly can sometimes be more cost-effective than relying on insurance, as the negotiated rates may not cover the full cost of care until deductibles are met. It is important to verify your specific plan's allowed amount before scheduling to ensure you understand your financial responsibility.
To minimize unexpected costs, patients should request an itemized bill that breaks down every service and code, as summary bills often hide errors or unbundled charges. Additionally, ask the hospital about "prompt-pay" discounts, which can reduce the total bill by 20% to 50% if paid in full upfront, bypassing the administrative overhead of insurance claims. If you receive a large bill after insurance processing, do not pay immediately; instead, request a formal written audit to identify any discrepancies or services not rendered. Finally, confirm whether the facility offers self-pay or cash-pay discounts before check-in, as these rates are frequently lower than the standard negotiated amounts listed for insurance plans.