CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Holyoke Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $49
Cash Discount Price: $76
vs. Medicare Baseline: 1.77x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Holyoke Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.77x the Medicare baseline. Located in 575 Beech Street, Holyoke, MA.

Cash / Self-Pay

$76

Average discount available for prompt cash payment at this facility.

Insurance Median

$49

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: $76 (274%)

Insurance Median: $49 (177%)

Cash: $76 (274% of Medicare)

Ins. Median: $49 (177% 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.

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
Aetna	$27 - $95	97%
Blue Cross Blue Shield	$27 - $171	97%
Health New England	$27 - $149	97%
Tufts Health Plan	$27 - $53	97%
UnitedHealthcare	$27 - $207	97%
Commonwealth Care Alliance	$29	105%
Fallon	$29 - $82	105%
Wellcare	$29	105%
Wellsense Sco	$29	105%
Senior Whole Health	$32	115%
Tufts Health Public Plans	$33	119%
Gic Unicare	$52	188%
Bmchp	$82	296%
Harvard Pilgrim	$95	343%
Wellsense Direct Metals Silver	$102	368%
Cigna	$170	613%

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 $76.
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 Holyoke Medical Center 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.