CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Merit Health Madison

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $49
  • Cash Discount Price: $26
  • vs. Medicare Baseline: 1.77x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Merit Health Madison is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.77x the Medicare baseline. Located in 161 River Oaks Drive, Canton, MS.
Cash / Self-Pay
$26

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $26 (94%)
Insurance Median: $49 (177%)
Cash: $26 (94% of Medicare)
Ins. Median: $49 (177% 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
Ms-Can-Molina $23 83%
Ms-Can-Magnolia $24 87%
Ms-Can-Truecare $24 87%
Medicare (plans) $26 94%
Devoted_Health $27 97%
Humana $27 97%
Wellcare $27 97%
Advhealth $30 108%
Blue Cross Blue Shield $35 126%
Mpcn $49 177%
Molina-Chip $50 180%
Magnolia-Chip $51 184%
Truecare-Chip $51 184%
Firstchoice $52 188%
Molina_Exchange $56 202%
Ambetter / Centene $64 231%
Cigna $64 231%
United $64 231%
United_Exchange $64 231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 161 River Oaks Drive, Canton, MS 39046
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals