CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: The Children's Mercy Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $59
Cash Discount Price: $54
vs. Medicare Baseline: 2.13x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at The Children's Mercy Hospital is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.13x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $54 (195%)

Insurance Median: $59 (213%)

Cash: $54 (195% of Medicare)

Ins. Median: $59 (213% 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 213% of the Medicare baseline (a markup of 113%). 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
Cigna	$13 - $85	47%
UnitedHealthcare	$23 - $83	83%
Healthy Blue	$25 - $71	90%
Home State Health	$26 - $63	94%
Medicaid / KanCare	$26	94%
Wppa Providrs Care	$31 - $80	112%
Healthlink	$34 - $108	123%
Blue Cross Blue Shield	$36 - $91	130%
Health Midwest Comprehensive Care	$36 - $80	130%
Quiktrip	$36 - $80	130%
American Healthcare Alliance	$38 - $105	137%
Aetna	$45 - $84	162%
Multiplan	$46 - $93	166%
Wellfit/Centrus	$50 - $80	180%
Centivo	$52 - $80	188%
Nebraska Furniture Mart	$52 - $80	188%
Humana	$54 - $82	195%
Orscheln	$54 - $80	195%
Coventry Health Care Of Kansas	$57 - $91	206%
Medica	$59 - $72	213%
Mercy Health	$74 - $92	267%
Coxhealth Network	$75 - $91	271%
National Preferred Provider Network	$89 - $111	321%

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 $54.
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 The Children's Mercy 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.