CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: The McDowell Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $39
  • Cash Discount Price: $113
  • vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at The McDowell Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.41x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.
Cash / Self-Pay
$113

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $113 (408%)
Insurance Median: $39 (141%)
Cash: $113 (408% of Medicare)
Ins. Median: $39 (141% 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
Amerihealth $14 - $19 51%
Blue Cross Blue Shield $14 - $18 51%
Partners Health Management $14 - $19 51%
United $14 - $69 51%
Vaya Health $14 - $19 51%
Wellcare $14 - $28 51%
Apex Health $21 - $27 76%
Aetna $24 - $97 87%
Alignment Health $24 - $27 87%
Devoted Health $24 - $27 87%
Humana $24 - $28 87%
Cigna $25 - $72 90%
Provider Partners Health Plan $25 - $28 90%
Troy Healthcare $25 - $29 90%
Healthteam Advantage $26 - $29 94%
Amerihealth Caritas $27 - $63 97%
Longevity Health Plan $28 - $32 101%
Caresource $46 - $59 166%
Medcost $51 - $114 184%
Magellan $62 - $81 224%
Magellan Behavioral Health $62 - $81 224%
Multiplan $83 - $108 299%
Avalon Administrative Services $88 - $114 317%
Prime Health $91 - $121 328%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 Rankin Drive P O Box 730, Marion, NC 28752
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals