Physical therapy (manual therapy)
Facility: Mitchell County Hospital Health Systems
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $80
- Cash Discount Price: $77
- vs. Medicare Baseline: 2.89x 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 289% of the Medicare baseline (a markup of 189%). 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 | $26 - $89 | 94% |
| Blue Cross Blue Shield | $50 | 180% |
| Triwest Well Mark All Plans | $69 - $76 | 249% |
| First Health-All Plans | $73 - $80 | 263% |
| Pref Hlth Care Sytms Comm - All Plans | $73 - $80 | 263% |
| Aetna | $73 - $80 | 263% |
| Multiplan Ppo - All Plans | $77 - $85 | 278% |
| Phc Leased Ntwrk Access - All Plans | $77 - $85 | 278% |
| Auxiant-All Plans | $77 - $85 | 278% |
| Health Partners Ks-All Plans | $80 - $88 | 289% |
| Cigna | $80 - $88 | 289% |
Consumer Guidance & Cost Commentary
For this physical therapy session at Mitchell County Hospital Health Systems in Beloit, KS, the facility's negotiated rates range from $26 to $89 depending on your specific insurance plan, with a median allowed amount of $80.00. This negotiated rate is notably higher than the facility's cash price of $77.00, which may be a more cost-effective option for patients with high-deductible plans who have not yet met their out-of-pocket limits. While the facility is a Critical Access Hospital owned by the local government, the commercial rates charged to insured members reflect standard administrative costs and contract dynamics that often exceed the true cost of care.
To ensure you are paying the lowest possible amount, it is important to verify your specific plan's allowed amount before scheduling, as in-network rates can vary significantly between carriers. You should also inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if you pay upfront, bypassing the administrative fees associated with insurance claims. Finally, remember that Medicare sets a benchmark rate of $27.72 for this service; comparing your commercial rate to this federal baseline rather than the hospital's full chargemaster list provides a clearer picture of whether the facility's pricing is reasonable for the care provided.