Physical therapy (manual therapy)
Facility: Golden Valley Memorial Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $26
- Cash Discount Price: $77
- vs. Medicare Baseline: 0.94x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $25 | 90% |
| Humana | $25 | 90% |
| UnitedHealthcare | $25 - $43 | 90% |
| Home State Health | $26 | 94% |
| Ambetter / Centene | $30 | 108% |
| Medica | $166 | 599% |
Consumer Guidance & Cost Commentary
Golden Valley Memorial Hospital in Clinton, Missouri, reports a cash median price of $77 for Physical therapy (manual therapy) under CPT code 97140. While the facility's gross charge is $128, the median negotiated rate for in-network payers is $26, and the Medicare amount is $27.72. For patients with high-deductible plans, paying the $77 cash price may be more cost-effective than using insurance, as the commercial negotiated rates can sometimes exceed the cash price due to administrative overhead and contract dynamics.
This facility is owned by a Government - Hospital District or Authority and holds a rating of 3 stars. The data indicates specific pricing tiers for major insurers, with rates ranging from $25 to $166 depending on the plan and payer, such as Aetna, Humana, and Medica. Patients are encouraged to verify their specific plan's allowed amount before scheduling to ensure they are not subject to higher negotiated rates or balance billing. Additionally, asking the hospital about self-pay or prompt-pay discounts prior to check-in can help bypass unnecessary claims processing costs and secure immediate fee reductions.