CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Wayne General Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $74
Cash Discount Price: $89
vs. Medicare Baseline: 2.67x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Wayne General Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.67x the Medicare baseline. Located in 950 Matthew Dr, Waynesboro, MS.

Cash / Self-Pay

$89

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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: $89 (321%)

Insurance Median: $74 (267%)

Cash: $89 (321% of Medicare)

Ins. Median: $74 (267% 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 267% of the Medicare baseline (a markup of 167%). 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
Humana	$23	83%
Al Healthcare Adv Mcaid-All Plans	$24	87%
Alabama Community Mcaid-All Plans	$24	87%
Medicaid / KanCare	$24	87%
Univita Healthcare Mcaid-All Plans	$24	87%
Amerigroup Mcare Adv-All Plans	$26	94%
Cigna	$26 - $63	94%
Magnolia Mcare Adv	$26	94%
Molina Chip-All Other Plans	$26	94%
Molina Mcare Adv	$26	94%
Vantage Health Mcare Adv	$26	94%
Wellcare Mcare Adv-All Plans	$26	94%
Ml Healthcare-All Plans	$35 - $36	126%
Vantage Health-All Other Plans	$59	213%
Ahs-All Plans	$61 - $63	220%
Phcs-All Plans	$65 - $68	234%
Mhci/Healthlink Op Only-All Plans	$74 - $76	267%
Ms Health Partners-All Plans	$74 - $76	267%
Ppoplus-All Plans	$74 - $76	267%
First Choice-All Other Plans	$78 - $81	281%
First Health-All Plans	$78 - $81	281%
Geha Ppo-All Plans	$78 - $81	281%
Healthcare Advantage-All Plans	$78 - $81	281%
United Providers-All Plans	$78 - $81	281%
Three Rivers Provider Network-All Plans	$83 - $86	299%
Aetna	$87 - $90	314%
Magnolia Comm/Exchange-All Other Plans	$87 - $90	314%
First Choice Hie	$109 - $112	393%
Blue Cross Blue Shield	$163 - $168	588%

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 $89.
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 Wayne General 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.