CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Caromont Regional Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $42
Cash Discount Price: $145
vs. Medicare Baseline: 1.52x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Caromont Regional Medical Center is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $145. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.52x the Medicare baseline. Located in 2525 Court Dr, Gastonia, NC.

Cash / Self-Pay

$145

Average discount available for prompt cash payment at this facility.

Insurance Median

$42

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: $145 (523%)

Insurance Median: $42 (152%)

Cash: $145 (523% of Medicare)

Ins. Median: $42 (152% 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.

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
Blue Cross Blue Shield	$21 - $40	76%
Carolina Complete Health	$21 - $22	76%
Partners Behavioral Health	$21 - $22	76%
Alliance Behavioral Health	$22 - $23	79%
Amerihealth Caritas	$22 - $23	79%
Carolina Complete Health Tailored Plans	$22 - $23	79%
UnitedHealthcare	$22 - $148	79%
Vaya Behavioral Health	$22 - $23	79%
Wellcare	$22 - $23	79%
Aetna	$28 - $74	101%
Devoted Health	$28	101%
Healthteam	$28	101%
Longevity Health	$28	101%
Molina	$28 - $42	101%
Humana	$29 - $131	105%
Absolute Total Care	$40 - $42	144%
Gaston County Jail	$42 - $45	152%
Surgery Plus	$47	170%
Cigna	$50 - $134	180%
Carolina Caring	$67 - $118	242%
Corporate Benefits Service	$72	260%
Medcost	$96 - $101	346%
Beech Street	$116 - $122	418%
Multiplan	$116 - $122	418%
Self Pay	$127 - $134	458%
First Health Network	$134 - $142	483%

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 $145.
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 Caromont Regional Medical Center 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.