CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: North Carolina Baptist Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $56
  • Cash Discount Price: $86
  • vs. Medicare Baseline: 2.02x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at North Carolina Baptist Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.02x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$86

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

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: $86 (310%)
Insurance Median: $56 (202%)
Cash: $86 (310% of Medicare)
Ins. Median: $56 (202% 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 202% of the Medicare baseline (a markup of 102%). 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
Aetna $26 - $150 94%
Apex $26 94%
Blue Cross Blue Shield $26 - $59 94%
Cigna $26 - $187 94%
Devoted $26 94%
Healthteam $26 94%
Humana $26 - $96 94%
Medicare (plans) $26 94%
UnitedHealthcare $26 - $61 94%
Wellcare $26 - $40 94%
Liberty $30 108%
Medcost $33 - $117 119%
Alliance $38 - $41 137%
Amerihealth $38 - $47 137%
Carolina Complete $38 - $40 137%
Health Blue $38 - $40 137%
Partners $38 - $40 137%
Vaya $38 - $40 137%
Trillium $39 - $41 141%
Ambetter / Centene $45 - $48 162%
Oscar $50 - $63 180%
Directnet $98 - $104 354%
Cone Health $116 - $123 418%
Healthgram $116 - $123 418%
First Carolina Care $133 - $141 480%
Private Healthcare Systems $136 - $144 491%
Multiplan $149 - $158 538%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals