Physical therapy (manual therapy)
Facility: Bob Wilson Memorial Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $100
- Cash Discount Price: $49
- vs. Medicare Baseline: 3.61x 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 361% of the Medicare baseline (a markup of 261%). 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 |
|---|---|---|
| Kansas Health | $39 | 141% |
| Aetna | $39 - $98 | 141% |
| Medicare (plans) | $39 | 141% |
| UnitedHealthcare | $39 - $102 | 141% |
| Humana | $39 | 141% |
| Centura Employee Plan | $72 | 260% |
| Blue Cross Blue Shield | $78 | 281% |
| Multiplan | $110 - $114 | 397% |
| Health Partners Of Kansas | $115 | 415% |
| Wppa | $116 | 418% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy (manual therapy) at Bob Wilson Memorial Hospital in Ulysses, KS, the facility's cash median rate is $49.00, which is significantly lower than the state average of $118.00. While the hospital's negotiated rates with major payers like Aetna and UnitedHealthcare range from $39 to $102, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and ask the hospital about self-pay or prompt-pay discounts before scheduling, as these upfront incentives can bypass administrative fees and reduce the final cost.
The facility's Medicare benchmark rate for this service is $27.72, which serves as a reliable baseline for evaluating pricing fairness, as commercial negotiated rates typically average between 200% and 300% of Medicare amounts. In this case, the median negotiated rate of $100.00 is approximately 3.6 times the Medicare amount, reflecting the standard markup found in commercial contracts. To ensure you are not overcharged, we recommend requesting a full itemized bill to review specific CPT codes and avoid summary bills that may obscure unbundled charges or services not rendered. If you receive a bill that appears inflated, you can dispute it in writing to the billing supervisor to correct any errors or double-billing before payment is finalized.