CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Essentia Health St Mary's Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $50
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 1.80x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Essentia Health St Mary's Medical Center is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.80x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $66 (238%)
Insurance Median: $50 (180%)
Cash: $66 (238% of Medicare)
Ins. Median: $50 (180% 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.

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
Advocare/Security Health $27 97%
Blue Cross Blue Shield $27 - $76 97%
Freedom Blue Ppo $27 97%
Healthpartners Care Msho / Mcr Adv $27 97%
Imcare Msho (Ref Req) $27 97%
Imcare Msho Pcc Prime $27 97%
Imcare Msho Ref Req $27 97%
Itasca Med Care $27 97%
Medica Advantage Solutions $27 97%
Medica Msho/Dual Solutions $27 97%
Medica Prime Solution Group $27 97%
Medicare (plans) $27 97%
Nd Va Administration $27 97%
Platinum Blue / Vantage Blue $27 97%
Primewest $27 97%
Primewest Msho $27 97%
Secure Blue Msho $27 97%
Ubh Cost Plan $27 97%
Ubh Msho $27 97%
Ucare Msho $27 97%
UnitedHealthcare $27 - $73 97%
Medica Access $33 119%
Healthpartners Care Pmap $40 144%
Sanford Health Plan $43 - $57 155%
Blue Plus Pmap Pcc Prime $44 - $50 159%
Medica $55 - $57 198%
Medica Uplan $55 198%
Healthpartners $60 - $72 216%
Medica Choice $61 220%
Ucare $66 238%
Cigna $72 260%
Healthpartners Pcc Prime $72 260%
Wea $72 - $77 260%
Security Health $77 278%
America'S Ppo $78 281%
Wps $83 - $84 299%
Aetna $85 307%
Healthscope Benefits $85 307%
Healtheos $86 310%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals