Physical therapy (manual therapy)
Facility: Girard Medical Center
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $43
- Cash Discount Price: $74
- vs. Medicare Baseline: 1.55x 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.
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 | $43 - $117 | 155% |
| Humana | $43 | 155% |
| Kansas Superior Select-All Plans | $43 | 155% |
| Medicare (plans) | $43 | 155% |
| Blue Cross Blue Shield | $43 - $58 | 155% |
| Ambetter / Centene | $43 | 155% |
| Aetna | $43 - $215 | 155% |
| Multiplan-All Plans | $114 | 411% |
| Uhhis-All Plans | $117 | 422% |
Consumer Guidance & Cost Commentary
For CPT code 97140, representing physical therapy with manual therapy at Girard Medical Center in Kansas, the facility's cash median rate is $74.00, which is significantly higher than the state average of $43.00. While commercial insurance plans like UnitedHealthcare and Aetna negotiate rates ranging from $43 to $215, the cash price remains the lowest fixed amount available for patients without insurance. This pricing structure highlights a common billing dynamic where cash-pay can be more cost-effective than insurance for those with high-deductible plans, as the negotiated rates often exceed the cash price. Patients are encouraged to verify their specific plan's allowed amount before scheduling, as some insurers may pay less than the cash rate, making out-of-pocket payment the most economical option.
The facility, a Critical Access Hospital in Girard, KS, operates under a government ownership model, and its pricing reflects the broader landscape of healthcare cost transparency. Although the facility's rating is 2, the data indicates that the median negotiated rate across all payers is $43.00, matching the state average and falling well below the gross chargemaster of $123.00. To ensure you are not overcharged, it is advisable to request a detailed itemized bill before finalizing payment, as summary invoices can obscure individual code costs. Additionally, patients should inquire about prompt-pay discounts, which can reduce the final balance by 20% to 50% if paid upfront, effectively bypassing the administrative overhead associated with insurance claims processing.