CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Essentia Health Holy Trinity Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $82
Cash Discount Price: $92
vs. Medicare Baseline: 2.96x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Essentia Health Holy Trinity Hospital is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.96x the Medicare baseline. Located in 115 Second Street West, Box 157, Graceville, MN.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

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: $92 (332%)

Insurance Median: $82 (296%)

Cash: $92 (332% of Medicare)

Ins. Median: $82 (296% 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 296% of the Medicare baseline (a markup of 196%). 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
Itasca Med Care	$27	97%
Primewest	$27	97%
Healthpartners Care Pmap	$49	177%
Medica Access	$50 - $78	180%
Sanford Healthplan	$54 - $56	195%
Blue Cross Blue Shield	$67 - $109	242%
Blue Plus Pmap Pcc Prime	$69 - $109	249%
Healthpartners	$76 - $83	274%
Advocare/Security Health	$78	281%
Freedom Blue Ppo	$78	281%
Healthpartners Care Msho / Mcr Adv	$78	281%
Imcare Msho Pcc Prime	$78	281%
Imcare Msho Ref Req	$78	281%
Medica Advantage Solutions	$78	281%
Medica Msho/Dual Solutions	$78	281%
Medica Prime Solution Group	$78	281%
Medicare (plans)	$78	281%
Nd Va Administration	$78	281%
Platinum Blue/Vantage Blue	$78	281%
Primewest Msho	$78	281%
Secure Blue Msho	$78	281%
Ubh Cost Plan	$78	281%
Ubh Msho	$78	281%
Ucare Msho	$78	281%
UnitedHealthcare	$78 - $113	281%
Ucare	$82	296%
Cigna	$83	299%
Healthpartners Pcc Prime	$83	299%
Wea	$90 - $96	325%
America'S Ppo	$97	350%
Medica	$104 - $109	375%
Medica Uplan	$104	375%
Wps	$104 - $105	375%
Aetna	$106	382%
Medica Choice	$113	408%

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 $92.
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 Essentia Health Holy Trinity Hospital 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.