CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Claiborne Memorial Medical Center
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $57
- Cash Discount Price: $74
- vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Claiborne Memorial Medical Center is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.06x the Medicare baseline. Located in 620 East College Street, Homer, LA.
Cash / Self-Pay
$74
Average discount available for prompt cash payment at this facility.
Insurance Median
$57
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: $74 (267%)
Insurance Median: $57 (206%)
Cash: $74 (267% of Medicare)
Ins. Median: $57 (206% 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 206% of the Medicare baseline (a markup of 106%). 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 |
|---|---|---|
| Aetna | $23 - $59 | 83% |
| Commercial Insurance | $23 - $90 | 83% |
| Meritain Health | $23 - $59 | 83% |
| Amerihealth Caritas La | $24 - $39 | 87% |
| Community Health Solution | $24 - $39 | 87% |
| Correctcare Intergrated | $24 - $39 | 87% |
| Healthy Blue | $24 - $39 | 87% |
| Humana | $24 - $90 | 87% |
| Louisiana Hc Connections | $24 - $39 | 87% |
| Magellan Services | $24 - $39 | 87% |
| Medicaid / KanCare | $24 - $39 | 87% |
| UnitedHealthcare | $24 - $39 | 87% |
| Arcadian Community Mcr Hm | $26 | 94% |
| Blue Cross Blue Shield | $26 - $87 | 94% |
| Champus | $26 | 94% |
| Champva | $26 | 94% |
| Cigna | $26 - $68 | 94% |
| Healthy Blue Dual Adv | $26 | 94% |
| Kaiser Foundation Health | $26 | 94% |
| Medicare (plans) | $26 | 94% |
| Peoples Health Network | $26 | 94% |
| Pyramid Claims Mcr Hmo | $26 | 94% |
| Sterling Connect 2 | $26 | 94% |
| Sterling Premier Mc Hmo | $26 | 94% |
| Superior Health Mcr Hmo | $26 | 94% |
| Tenet Mcr Hmo | $26 | 94% |
| Tricare | $26 | 94% |
| United Hc Mcr Hmo | $26 | 94% |
| Universal Hc Mcr Hmo | $26 | 94% |
| Us Dept Of Labor | $26 | 94% |
| Vantage Health Mcr Hmo | $26 | 94% |
| Windsor Sterling Mcr Hmo | $26 | 94% |
| Wps Mvh Vapc3 | $26 | 94% |
| Vantage Health Plan Inc | $27 - $30 | 97% |
| Coventry Healthcare | $34 - $54 | 123% |
| Geha | $40 - $63 | 144% |
| Health Plus Of La | $40 - $68 | 144% |
| Apwu Healthplan | $43 - $68 | 155% |
| Great West Healthcare | $43 - $68 | 155% |
| Sedgwick Claims Mgmt Serv | $44 - $81 | 159% |
| Workman'S Comp | $44 - $81 | 159% |
| Phcs | $46 - $72 | 166% |
| Ppo Plus | $46 - $72 | 166% |
| Aarp | $57 - $90 | 206% |
| Accordia National | $57 - $90 | 206% |
| Aflac | $57 - $90 | 206% |
| Alameda Alliance Forhealt | $57 - $90 | 206% |
| American Pioneer | $57 - $90 | 206% |
| Benefit Management | $57 - $90 | 206% |
| Benesys Inc | $57 - $90 | 206% |
| Business Guarantor | $57 - $90 | 206% |
| Chubb | $57 - $90 | 206% |
| Commercial Sr. Care | $57 - $90 | 206% |
| Employee Benefit Services | $57 - $90 | 206% |
| Family Life Insurance Co | $57 - $90 | 206% |
| Farm Bureau Insurance | $57 - $90 | 206% |
| Fiserv Health Benefit | $57 - $90 | 206% |
| Gmp | $57 - $90 | 206% |
| Group And Pension Admin | $57 - $90 | 206% |
| Group Resources | $57 - $90 | 206% |
| Haik Minvielle And Grubbs | $57 - $90 | 206% |
| Harrington Benefit Svs | $57 - $90 | 206% |
| Health Design Plus | $57 - $90 | 206% |
| Health Plan | $57 - $90 | 206% |
| Healthscope Benefits | $57 - $90 | 206% |
| Insurance Management Admi | $57 - $90 | 206% |
| Jefferson National | $57 - $90 | 206% |
| John Alden Health Ins | $57 - $90 | 206% |
| John Hancock | $57 - $90 | 206% |
| Liberty Mutual | $57 - $90 | 206% |
| Mailhandlers Benefit Plan | $57 - $90 | 206% |
| Manhattan Life Ins Co | $57 - $90 | 206% |
| Mega Life And Health | $57 - $90 | 206% |
| Msa Careguard | $57 - $90 | 206% |
| Mutual Of Omaha | $57 - $90 | 206% |
| Nalc Health Benefit Plan | $57 - $90 | 206% |
| Naphcare Inc. | $57 - $90 | 206% |
| New Era Life Ins Co | $57 - $90 | 206% |
| Physicians Mutual | $57 - $90 | 206% |
| Principal Financial Group | $57 - $90 | 206% |
| Prudential Healthcare | $57 - $90 | 206% |
| Self Pay | $57 - $90 | 206% |
| State Farm | $57 - $90 | 206% |
| State Farm Insurance | $57 - $90 | 206% |
| State Mutual Insurance Co | $57 - $90 | 206% |
| Sterling Investors Life | $57 - $90 | 206% |
| Tower Life | $57 - $90 | 206% |
| Transamerica Premier Ins | $57 - $90 | 206% |
| United American | $57 - $90 | 206% |
| United Comm Travelers | $57 - $90 | 206% |
| United Teachers | $57 - $90 | 206% |
| Usable Administrator | $57 - $90 | 206% |
| Visn 16 Cfu | $57 - $90 | 206% |
| Wausau Benefits | $57 - $90 | 206% |
| Webtpa | $57 - $90 | 206% |
| Wells Fargo | $57 - $90 | 206% |
| Woodmen Of The World | $57 - $90 | 206% |