Physical therapy (manual therapy)
Facility: Children'S Mercy South
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $59
- Cash Discount Price: $54
- vs. Medicare Baseline: 2.13x 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 213% of the Medicare baseline (a markup of 113%). 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 |
|---|---|---|
| Cigna | $13 - $85 | 47% |
| UnitedHealthcare | $23 - $83 | 83% |
| Healthy Blue | $25 - $71 | 90% |
| Medicaid / KanCare | $26 | 94% |
| Home State Health | $26 - $63 | 94% |
| Wppa Providrs Care | $31 - $80 | 112% |
| Healthlink | $34 - $108 | 123% |
| Blue Cross Blue Shield | $36 - $91 | 130% |
| Quiktrip | $36 - $80 | 130% |
| Health Midwest Comprehensive Care | $36 - $80 | 130% |
| American Healthcare Alliance | $38 - $105 | 137% |
| Aetna | $45 - $84 | 162% |
| Multiplan | $46 - $93 | 166% |
| Wellfit/Centrus | $50 - $80 | 180% |
| Centivo | $52 - $80 | 188% |
| Nebraska Furniture Mart | $52 - $80 | 188% |
| Orscheln | $54 - $80 | 195% |
| Humana | $54 - $82 | 195% |
| Coventry Health Care Of Kansas | $57 - $91 | 206% |
| Medica | $59 - $72 | 213% |
| Mercy Health | $74 - $92 | 267% |
| Coxhealth Network | $75 - $91 | 271% |
| National Preferred Provider Network | $89 - $111 | 321% |
Consumer Guidance & Cost Commentary
For CPT code 97140, Physical therapy (manual therapy), the facility's cash median rate of $54.00 is significantly lower than the negotiated rates charged by most insurance payers, which range from $23 to $111 depending on the plan. While the facility's cash price is competitive, it is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures. Patients with high-deductible plans may find paying the cash rate directly more beneficial than relying on insurance, as the insurer's allowed amount could be higher than the cash price. To maximize savings, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final cost.
This service is located in Overland Park, KS, and the facility's pricing is benchmarked against Medicare, which sets the objective baseline for healthcare costs. The Medicare amount for this procedure is $27.72, and the facility's cash rate of $54.00 represents a markup of approximately 2.1 times the Medicare rate. While commercial negotiated rates vary widely across the 23 participating payers, the cash price offers a transparent alternative to the complex billing cycles of insurance. Consumers are advised to review their specific plan details to understand if their deductible has been met and to request an itemized bill if they choose to use insurance, ensuring there are no errors or unbundled charges that could inflate the final bill.