Physical therapy (manual therapy)
Facility: Amberwell Atchison Association
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $99
- Cash Discount Price: $193
- vs. Medicare Baseline: 3.57x 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 357% of the Medicare baseline (a markup of 257%). 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 | $55 - $58 | 198% |
| Superior Select Mcr Adv - All Plans | $64 | 231% |
| Humana | $64 - $87 | 231% |
| UnitedHealthcare | $64 - $346 | 231% |
| Triwest - All Plans | $64 | 231% |
| Va Ccn - All Plans | $64 | 231% |
| Ambetter / Centene | $99 | 357% |
| Aetna | $106 | 382% |
| Cigna | $106 | 382% |
| Centrus Health Direct - All Plans | $145 | 523% |
| Oscar - All Plans | $145 | 523% |
| Multiplan - All Plans | $151 | 545% |
| Wppa Providrs Care - All Plans | $174 | 628% |
Consumer Guidance & Cost Commentary
For this physical therapy service at Amberwell Atchison Association, the cash price is $193.00, which matches the facility's median negotiated rate. This cash price is significantly higher than the state average for this procedure, which is $74.00. While commercial insurance plans like Blue Cross Blue Shield and Humana have negotiated rates ranging from $55 to $346, these amounts often exceed the cash price. Patients with high-deductible plans may find it more cost-effective to pay the $193.00 cash price directly, as their insurance allowed amounts could be higher, resulting in out-of-pocket costs that surpass the cash rate.
To maximize savings, patients should verify if the facility offers prompt-pay discounts, which can reduce the bill by 20% to 50% for upfront payment. It is crucial to request self-pay classification and prompt-pay rates before scheduling to avoid automatic claims submission that voids cash agreements. Additionally, patients should review their itemized bills carefully, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. When evaluating the facility's pricing, it is important to compare rates against the Medicare benchmark of $27.72 rather than the hospital's gross charges, as commercial rates often include administrative markups that inflate the baseline price.