CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: North Adams Regional Hospital Corporation

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $70
  • Cash Discount Price: $114
  • vs. Medicare Baseline: 2.53x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at North Adams Regional Hospital Corporation is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.53x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$114

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $114 (411%)
Insurance Median: $70 (253%)
Cash: $114 (411% of Medicare)
Ins. Median: $70 (253% 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 253% of the Medicare baseline (a markup of 153%). 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.

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
Mcd Masshealth $21 - $147 76%
Mcd New York $21 - $73 76%
Mcd Out Of State $21 - $147 76%
Mcdmanaged Cdphp $21 - $147 76%
Mcdmanaged Hne Mcdaco $21 - $147 76%
Medicaid / KanCare $21 - $147 76%
Comm Network Qhpsub $23 - $68 83%
Mcdmanaged Network $23 - $68 83%
Mcdmanaged Bmchnp $24 - $153 87%
Blue Cross Blue Shield $27 - $102 97%
Mcrmanaged Cca One Care $27 - $32 97%
Medicare (plans) $27 - $30 97%
Comm Hospice $28 - $29 101%
Mcr Miscellaneous $28 - $29 101%
Mcrmanaged Usa Family $28 - $29 101%
Mcrmanaged Va $28 - $29 101%
Oth United Vaccn $28 - $29 101%
Tricare $28 - $45 101%
Aetna $34 - $91 123%
Comm Fallon Qhp $42 - $68 152%
Comm Hne Hmo $51 - $83 184%
Comm Hne $54 - $88 195%
Comm Hne Ppo $54 - $88 195%
Comm Unicare $63 - $78 227%
Wc Workers Comp $73 263%
Comm Network Qhpnonsub $77 - $86 278%
Comm Nhp $78 281%
Comm Tufts $95 343%
UnitedHealthcare $103 372%
Cigna $108 - $112 390%
Comm Cdphp $108 390%
Comm Mvp $108 390%
Comm Oxford $108 390%
Comm First Health $112 - $114 404%
Comm Connecticare $114 411%
Comm Consolidated Health $114 411%
Comm Harvard $114 411%
Comm Other $114 411%
Comm Phcs $114 411%
Comm Self Pay $114 411%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals