CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Atrium Health Cleveland

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $106
  • Cash Discount Price: $122
  • vs. Medicare Baseline: 3.82x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Atrium Health Cleveland is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.82x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.
Cash / Self-Pay
$122

Average discount available for prompt cash payment at this facility.

Insurance Median
$106

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: $122 (440%)
Insurance Median: $106 (382%)
Cash: $122 (440% of Medicare)
Ins. Median: $106 (382% 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 382% of the Medicare baseline (a markup of 282%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Alliance $21 - $41 76%
Amerihealth Caritas $21 - $34 76%
Carolina Complete Health $21 - $35 76%
Healthy Blue $21 - $35 76%
Partners $21 - $34 76%
Trillium $21 - $36 76%
UnitedHealthcare $21 - $131 76%
Vaya $21 - $36 76%
Wellcare $21 - $35 76%
Cigna $26 - $196 94%
Aetna $27 - $188 97%
Humana $27 97%
Blue Cross Blue Shield $44 - $100 159%
Ambetter / Centene $78 - $89 281%
Employers Health Network $108 390%
Physician Reach Out $122 440%
Medcost $136 - $162 491%
Magellan $147 530%
Gmmi $159 574%
Quik Trip $159 574%
Carolina Behavioral Health $176 - $196 635%
Healthgram $196 707%
Choicecare $200 722%
First Health $208 750%
Lifesynch Community Choice Care $208 750%
Private Health Care Systems $220 794%
Beechstreet $225 812%
Multiplan $232 837%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 E Grover St, Shelby, NC 28150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals