CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Trinity Health Livingston Hospital
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $166
- Cash Discount Price: $148
- vs. Medicare Baseline: 5.99x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Trinity Health Livingston Hospital is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $148. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 5.99x the Medicare baseline. Located in 620 Byron Rd, Howell, MI.
Cash / Self-Pay
$148
Average discount available for prompt cash payment at this facility.
Insurance Median
$166
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: $148 (534%)
Insurance Median: $166 (599%)
Cash: $148 (534% of Medicare)
Ins. Median: $166 (599% 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 599% of the Medicare baseline (a markup of 499%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $15 - $81 | 54% |
| Medicaid / KanCare | $15 | 54% |
| Huron Valley Pace | $25 | 90% |
| Aetna | $26 - $153 | 94% |
| Blue Care Network Advantage | $26 | 94% |
| Hospice Of Lansing | $26 | 94% |
| Medicare (plans) | $26 - $27 | 94% |
| Align Senior Care | $27 | 97% |
| Angela Hospice | $28 | 101% |
| Cca - Zing Health | $28 | 101% |
| UnitedHealthcare | $28 - $204 | 101% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $30 | 108% |
| Molina Marketplace | $35 | 126% |
| Health Cost Solutions | $41 | 148% |
| Vitalcore | $41 | 148% |
| Wellpath | $41 | 148% |
| U Of M Health Plan | $42 | 152% |
| Wc Accident Fund | $50 | 180% |
| Wc Advantage | $50 | 180% |
| Wc Aig | $50 | 180% |
| Wc Allied | $50 | 180% |
| Wc Amerisure | $50 | 180% |
| Wc Amtrust | $50 | 180% |
| Wc Asu Risk Mgt | $50 | 180% |
| Wc Berkley Admin | $50 | 180% |
| Wc Broadspire | $50 | 180% |
| Wc Bunch & Associates | $50 | 180% |
| Wc Ccmsi | $50 | 180% |
| Wc Emc Insurance Company | $50 | 180% |
| Wc Esis | $50 | 180% |
| Wc Fcci | $50 | 180% |
| Wc Federated | $50 | 180% |
| Wc Gallagher Bassett | $50 | 180% |
| Wc Genex Care For Ohio | $50 | 180% |
| Wc Guard Insurance Company | $50 | 180% |
| Wc Hartford | $50 | 180% |
| Wc Liberty Mutual | $50 | 180% |
| Wc Meijers | $50 | 180% |
| Wc Michigan | $50 | 180% |
| Wc Mitchell Frankenmuth | $50 | 180% |
| Wc Pma | $50 | 180% |
| Wc Sedgwick | $50 | 180% |
| Wc Sentry | $50 | 180% |
| Wc Travelers | $50 | 180% |
| Wc Tristar | $50 | 180% |
| Wc Walmart | $50 | 180% |
| Wc Zurich | $50 | 180% |
| Priority Health | $53 - $58 | 191% |
| Employee Benefit Logistic | $60 | 216% |
| Asr Health Benefits | $75 | 271% |
| Caresource | $75 | 271% |
| Hap | $75 - $176 | 271% |
| Varipro | $75 | 271% |
| Bcn Domestic | $81 | 292% |
| Blue Benefit Administrators Of Massachusetts | $81 | 292% |
| Blue Care Network | $81 | 292% |
| Blue Distinction Transplant | $81 | 292% |
| Blue Shield - Ca | $81 | 292% |
| Blue Shield - Id (Regence) | $81 | 292% |
| Blue Shield - Ny Highmark Northeastern | $81 | 292% |
| Blue Shield - Ny Highmark Western | $81 | 292% |
| Blue Shield - Pa (Highmark) | $81 | 292% |
| Blue Shield - Wa (Regence) | $81 | 292% |
| Health Choices | $81 - $185 | 292% |
| Kaiser Domestic | $81 | 292% |
| Acs Benefit Services | $107 | 386% |
| Allied Benefit Systems | $107 | 386% |
| Claimchoice Adminstrators | $107 | 386% |
| Consociate | $107 | 386% |
| Cypress Benefit Administrators | $107 | 386% |
| Forest County Potawatomi | $107 | 386% |
| Health Smart | $107 | 386% |
| Healthgram | $107 | 386% |
| Healthscope | $107 | 386% |
| Secureone Preferred United Plans | $107 | 386% |
| Sisco Benefits | $107 | 386% |
| The Health Plan | $107 | 386% |
| Trustmark Small Business Benefits | $107 | 386% |
| Unified Group Services | $107 | 386% |
| Webtpa | $107 | 386% |
| Geha | $153 - $166 | 552% |
| Meritain | $153 | 552% |
| Hospice Advantage | $159 | 574% |
| 1199 National Benefit Fund | $175 | 631% |
| Allied National Global Care | $175 | 631% |
| Asrm - Reliance Standard Life Insurance | $175 | 631% |
| Christian Care Ministry | $175 | 631% |
| Dean Health | $175 | 631% |
| Fallon Health | $175 | 631% |
| Family Life Insurance Company | $175 | 631% |
| Ghc Scw | $175 | 631% |
| Group Pension Administrators | $175 | 631% |
| International Benefit Administrators | $175 | 631% |
| Lifetime Benefit Solutions | $175 | 631% |
| Manhattan Life | $175 | 631% |
| Medi Share | $175 | 631% |
| Multiplan | $175 | 631% |
| Mvp | $175 | 631% |
| Pai | $175 | 631% |
| Pan-American Life | $175 | 631% |
| Paramount Hmo | $175 | 631% |
| Phcs | $175 | 631% |
| Trinity Health Share | $175 | 631% |
| Cigna | $176 | 635% |
| Health Partners | $176 | 635% |
| Tufts Health Plan | $176 | 635% |
| Prime Health Services | $182 | 657% |
| Access Health | $185 | 667% |
| Acclaim | $185 | 667% |
| Administrative Concepts | $185 | 667% |
| Allegeant | $185 | 667% |
| Ameriben | $185 | 667% |
| American Family | $185 | 667% |
| American Healthcare Alliance | $185 | 667% |
| American National | $185 | 667% |
| American Republic | $185 | 667% |
| Amerihealth | $185 | 667% |
| Aultcare | $185 | 667% |
| Automated Benefit Services | $185 | 667% |
| Auxiant | $185 | 667% |
| Benefit Administrative Systems,Llc | $185 | 667% |
| Boon Chapman | $185 | 667% |
| Cam Administrative Services | $185 | 667% |
| Christian Brother Services | $185 | 667% |
| Christian Brothers Holy Cross | $185 | 667% |
| Comprehensive Benefits | $185 | 667% |
| Continental Life Insurance | $185 | 667% |
| Coventry | $185 | 667% |
| Custom Benefit Administrators | $185 | 667% |
| Employee Benefit Concepts | $185 | 667% |
| Employee Benefit Management | $185 | 667% |
| Enterprise Group Planning | $185 | 667% |
| Freedom Life Insurance Company | $185 | 667% |
| Group Administrators | $185 | 667% |
| Group Marketing Services | $185 | 667% |
| Guardian | $185 | 667% |
| Health America | $185 | 667% |
| Healthcare Management Admin | $185 | 667% |
| Healthez | $185 | 667% |
| Humana | $185 | 667% |
| Insight | $185 | 667% |
| Intercare | $185 | 667% |
| Jfp Benefit Management | $185 | 667% |
| Jp Farley Corporation | $185 | 667% |
| Key Benefit Administrator | $185 | 667% |
| Liberty Union Life Assurance Co | $185 | 667% |
| Lucent Health | $185 | 667% |
| Luminare Health | $185 | 667% |
| Luminare Health (Detroit) | $185 | 667% |
| Magnacare | $185 | 667% |
| Medben | $185 | 667% |
| Medcost | $185 | 667% |
| Medical Mutual | $185 | 667% |
| Mutual Health Services | $185 | 667% |
| Mutual Of Omaha | $185 | 667% |
| Ncas | $185 | 667% |
| Nippon Life Ins | $185 | 667% |
| Nova | $185 | 667% |
| Painters Union Insurance Fund | $185 | 667% |
| Physicians Mutual | $185 | 667% |
| Plumbers Local 98 Insurance Fund | $185 | 667% |
| Prairie States | $185 | 667% |
| Preferred One | $185 | 667% |
| Primary Physician Care | $185 | 667% |
| Professional Benefit Administrators | $185 | 667% |
| Siho Insurance Services | $185 | 667% |
| The Loomis Company | $185 | 667% |
| Unicare | $185 | 667% |
| Us Health And Life | $185 | 667% |
| Valenz | $185 | 667% |
| Western & Southern Financial Group | $185 | 667% |
| Wps | $185 | 667% |
| First Health | $190 | 685% |
| Correctional Healthcare Consultants | $201 | 725% |
| Three Rivers Provider Network | $204 | 736% |
| Cmh Washtenaw County | $227 | 819% |