CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $80
Cash Discount Price: $241
vs. Medicare Baseline: 2.89x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at UMass Memorial Healthalliance Hospitals is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.89x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$241

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $241 (869%)

Insurance Median: $80 (289%)

Cash: $241 (869% of Medicare)

Ins. Median: $80 (289% 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 289% of the Medicare baseline (a markup of 189%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Champva [11001]	$22	79%
Workers Compensation [20501]	$22	79%
Blue Cross Blue Shield	$29 - $249	105%
Cigna	$29 - $78	105%
Commonwealth Care Mcr [10115]	$29	105%
Correctional Care [11003]	$29 - $45	105%
Harvard Pilgrim Mcr [10106]	$29	105%
Institution [10406]	$29 - $128	105%
Medicare (plans)	$29	105%
Mgb Mcr [10124]	$29	105%
Tufts Dual [10111]	$29	105%
Tufts Us Family [11203]	$29	105%
Aetna	$30 - $158	108%
Fallon Mcr Supp [20202]	$30	108%
Senior Whole Health [10110]	$30	108%
Tufts Mcr [10112]	$30	108%
UnitedHealthcare	$30 - $241	108%
Tufts Connectorcare [10507]	$47	170%
Wellpoint [11112]	$67	242%
Tufts [11201]	$71	256%
Medicaid / KanCare	$84 - $125	303%
Hne [11108]	$134	483%
Fallon Connectorcare [10503]	$148	534%
First Health Network [11120]	$181	653%
Multiplan [11109]	$181	653%
Harvard Pilgrim [10701]	$185 - $222	667%
Connecticare [11105]	$241	869%
Fallon Carelon Hlth [28]	$241	869%
Fallon Mcaid Carelon Hlth [29]	$241	869%
Grants [20507]	$241	869%
Hsno/Free Care [10801]	$294	1061%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $241.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97140.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UMass Memorial Healthalliance Hospitals is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97140.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.