CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: University of Michigan Health - West

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $126
Cash Discount Price: $70
vs. Medicare Baseline: 4.55x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at University of Michigan Health - West is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.55x the Medicare baseline. Located in 5900 Byron Center Avenue, Sw, Wyoming, MI.

Cash / Self-Pay

$70

Average discount available for prompt cash payment at this facility.

Insurance Median

$126

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: $70 (253%)

Insurance Median: $126 (455%)

Cash: $70 (253% of Medicare)

Ins. Median: $126 (455% 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 455% of the Medicare baseline (a markup of 355%). 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
Priority Health	$7 - $36	25%
Web Tpa	$7 - $88	25%
Aetna	$10 - $134	36%
Alliance Health & Life Ppo	$10 - $134	36%
Asr Physicians	$10 - $134	36%
Hap	$10 - $134	36%
Golden Rule Ins	$11 - $144	40%
Humana	$11 - $150	40%
Medica	$11 - $144	40%
Student Ins/Mega Life	$11 - $144	40%
UnitedHealthcare	$11 - $144	40%
Asr Cofinity	$13 - $167	47%
Cofinity Commercial	$13 - $167	47%
Cofinity Weyco	$13 - $167	47%
Core Source	$13 - $167	47%
Epoch Group	$13 - $167	47%
Health Partners	$13 - $167	47%
Hlthcomp Admin	$13 - $167	47%
Mid America	$13 - $167	47%

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 $70.
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 University of Michigan Health - West 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.