Physical therapy (manual therapy)
Facility: William Newton Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $43
- Cash Discount Price: $114
- 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 |
|---|---|---|
| Triwest- All Plans | $36 - $42 | 130% |
| UnitedHealthcare | $37 - $108 | 133% |
| Ambetter / Centene | $37 - $120 | 133% |
| Blue Cross Blue Shield | $37 - $55 | 133% |
| Providrs Care Nexus | $63 - $73 | 227% |
| Providrs Care - All Other Plans | $72 - $84 | 260% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy at William Newton Hospital in Winfield, KS, the cash median price is $114.00. This cash rate is notably higher than the state average, which is $27.72, and significantly exceeds the Medicare benchmark of $27.72. While the facility's negotiated rates with major payers like UnitedHealthcare and Ambetter / Centene range from $37 to $120, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying cash directly. It is important to note that commercial insurance contracts can include administrative overheads that inflate the baseline price, and patients should verify their specific plan's allowed amount before scheduling to ensure they are not paying more than necessary.
Patients should be aware that the facility's gross charges are not the final amount owed, as hospitals often offer prompt-pay discounts for upfront payment. Since over 80% of hospital bills contain errors, consumers are strongly advised to request a full itemized CPT-coded bill before paying or negotiating, rather than accepting a summary invoice that obscures individual line items. If a balance bill arises from out-of-network ancillary services, the No Surprises Act provides federal protections against being billed for the difference between the chargemaster and the insurance allowed amount. To avoid unexpected costs, patients should explicitly ask for self-pay classification and prompt-pay rates prior to check-in and sign a waiver of insurance submission if they choose to pay cash.