CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Blue Ridge Regional Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $47
  • Cash Discount Price: $122
  • vs. Medicare Baseline: 1.70x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Blue Ridge Regional Hospital is $47. 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 1.70x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
$122

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $47 (170%)
Cash: $122 (440% of Medicare)
Ins. Median: $47 (170% 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
Blue Cross Blue Shield $15 - $25 54%
Amerihealth $16 - $26 58%
Partners Health Management $16 - $26 58%
United $16 - $70 58%
Vaya Health $16 - $26 58%
Wellcare $16 - $26 58%
Aetna $18 - $107 65%
Apex Health $18 - $30 65%
Cigna $31 - $60 112%
Amerihealth Caritas $34 - $55 123%
Caresource $40 - $65 144%
Medcost $43 - $76 155%
Magellan $55 - $89 198%
Magellan Behavioral Health $55 - $89 198%
Multiplan $74 - $118 267%
Avalon Administrative Services $78 - $125 281%
Prime Health $81 - $133 292%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals