CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Avoyelles Hospital
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $95
- Cash Discount Price: $32
- vs. Medicare Baseline: 3.43x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Avoyelles Hospital is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.43x the Medicare baseline. Located in 4231 Highway 1192, Marksville, LA.
Cash / Self-Pay
$32
Average discount available for prompt cash payment at this facility.
Insurance Median
$95
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$27.72
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $27.72 (100%)
Cash / Self-Pay: $32 (115%)
Insurance Median: $95 (343%)
Cash: $32 (115% of Medicare)
Ins. Median: $95 (343% of 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 343% of the Medicare baseline (a markup of 243%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| All Savers | $21 | 76% |
| Geha | $21 | 76% |
| United Hlth One | $21 | 76% |
| UnitedHealthcare | $21 - $26 | 76% |
| Aetna | $22 - $59 | 79% |
| Cigna | $22 - $60 | 79% |
| Correct Cr Int Hlt | $22 | 79% |
| Mcd Amerihealth Caritas | $22 | 79% |
| Mcd Healthy Blue | $22 | 79% |
| Mcd La Hc Conn | $22 | 79% |
| Medicaid / KanCare | $22 | 79% |
| Mcd Ms | $24 | 87% |
| Humana | $25 - $60 | 90% |
| Bankers Life | $26 | 94% |
| Champva | $26 | 94% |
| Mcr Lagniappe | $26 | 94% |
| Medeico Ins Co | $26 | 94% |
| Medicare (plans) | $26 | 94% |
| Mmc Allwell | $26 | 94% |
| Mmc Blue Advantage | $26 | 94% |
| Mmc Healthy Blue Dual Adv | $26 | 94% |
| Mmc Mcr Hmo Miscellaneous | $26 | 94% |
| Mmc Priority Hlth Pffs | $26 | 94% |
| Mmc Vantage Hlth | $26 | 94% |
| Mmc Wellcare | $26 | 94% |
| Mutual Of Omaha | $26 | 94% |
| Neba Inc | $26 | 94% |
| Philadelphia American Lif | $26 | 94% |
| Sentinel Security Life | $26 | 94% |
| Trustmark Health Benefits | $26 - $106 | 94% |
| Tunica Biloxi | $26 - $106 | 94% |
| United Amer Ins | $26 | 94% |
| Veterans Evaluation Serv | $26 | 94% |
| Wps Vacca | $26 | 94% |
| Student Assurances | $32 - $106 | 115% |
| Gulf South Zelis | $34 | 123% |
| Amer Contl Ins | $39 - $59 | 141% |
| Coventry | $39 - $59 | 141% |
| First Choice Health | $39 - $59 | 141% |
| Meritan Health | $39 - $106 | 141% |
| Blue Cross Blue Shield | $43 | 155% |
| Ofc Of Grp Bene | $43 | 155% |
| Ppo Plus Llc | $63 | 227% |
| Zelis Healthcare Bpa | $63 | 227% |
| Gilsbar | $66 | 238% |
| Amerind | $95 | 343% |
| Applied Underwriters | $95 | 343% |
| Sedgwick | $95 | 343% |
| Us Dept Of Labor | $95 | 343% |
| Wc Clms Admin Svcs | $95 | 343% |
| Wc Clms Mgmnt Walmart | $95 | 343% |
| Wc Esis | $95 | 343% |
| Wc Fara | $95 | 343% |
| Wc Gallagher Bassett | $95 | 343% |
| Wc Guide One | $95 | 343% |
| Wc Hartford Med | $95 | 343% |
| Wc Luba | $95 | 343% |
| Wc Lwcc | $95 | 343% |
| Wc Paragon Casino Resort | $95 | 343% |
| Wc Risk Mgmnt | $95 | 343% |
| Wc Stone Trust | $95 | 343% |
| Wc Summit Consulting Hold | $95 | 343% |
| Wc Travelers Ins | $95 | 343% |
| Wc Trs Workers Comp Claim | $95 | 343% |
| Wc Us Dol | $95 | 343% |
| Wc Zurich | $95 | 343% |
| Aarp | $106 | 382% |
| Admin Concepts | $106 | 382% |
| All Saints Hospice | $106 | 382% |
| All State | $106 | 382% |
| Allegiance Health Hospice | $106 | 382% |
| Allied Natl | $106 | 382% |
| Amfirst | $106 | 382% |
| Avoy Parish School Board | $106 | 382% |
| Avoyelles Parish Sheriff | $106 | 382% |
| Bollinger | $106 | 382% |
| Ccmsi | $106 | 382% |
| Central States | $106 | 382% |
| Christus Health Plan | $106 | 382% |
| Compassionate Care Hospic | $106 | 382% |
| Core Source | $106 | 382% |
| Coushatta Hlth Dept | $106 | 382% |
| Ebms | $106 | 382% |
| Federated Ins | $106 | 382% |
| Feedom Life | $106 | 382% |
| Fidelity Standard Life Co | $106 | 382% |
| Fox Everette | $106 | 382% |
| Guarantee Trust | $106 | 382% |
| Heart Of Hospice | $106 | 382% |
| Hos Christus Hospice | $106 | 382% |
| Hos Guardian Hospice Care | $106 | 382% |
| Hos Harbor Hospice Alex | $106 | 382% |
| Hos La Hospice Palliative | $106 | 382% |
| Hos Passages Hospice N. | $106 | 382% |
| Hos St Joseph Hospice | $106 | 382% |
| Hospice Miscellaneous | $106 | 382% |
| Ins Mgmnt Admin | $106 | 382% |
| Ins Tpa | $106 | 382% |
| Liberty Health Share | $106 | 382% |
| Lumico | $106 | 382% |
| Manhattan Life Ins | $106 | 382% |
| Medi Share | $106 | 382% |
| Misc Comm | $106 | 382% |
| Nalc | $106 | 382% |
| New Era Life | $106 | 382% |
| North American | $106 | 382% |
| Phcs | $106 | 382% |
| Physicians Mutual | $106 | 382% |
| Pipeline Ind Bene | $106 | 382% |
| Progressive Auto | $106 | 382% |
| Reliance Standard Life | $106 | 382% |
| Rural Carriers | $106 | 382% |
| Shelter Ins Co | $106 | 382% |
| Sierre Health And Life | $106 | 382% |
| State Farm | $106 | 382% |
| State Mutual | $106 | 382% |
| Sterling Investors | $106 | 382% |
| The Health Plan | $106 | 382% |
| Tribal Hlth Partners | $106 | 382% |
| Tricare | $106 | 382% |
| Uct | $106 | 382% |
| Unified Life | $106 | 382% |
| Usaa Life Ins | $106 | 382% |
| Web-Tpa | $106 | 382% |
| Woodmen Of The World | $106 | 382% |