CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Howard County Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $210
Cash Discount Price: $307
vs. Medicare Baseline: 7.58x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Howard County Medical Center is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $307. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 7.58x the Medicare baseline. Located in P O Box 406, 1113 Sherman St, St Paul, NE.

Cash / Self-Pay

$307

Average discount available for prompt cash payment at this facility.

Insurance Median

$210

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: $307 (1108%)

Insurance Median: $210 (758%)

Cash: $307 (1108% of Medicare)

Ins. Median: $210 (758% 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 758% of the Medicare baseline (a markup of 658%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$22	79%
Medica Standard Premier	$25	90%
Aetna	$26 - $466	94%
Blue Cross Blue Shield	$26 - $466	94%
Great Plains	$26 - $279	94%
Medica Chi	$26 - $279	94%
Medica Elevate	$26 - $50	94%
Tricare	$26 - $368	94%
UnitedHealthcare	$26 - $470	94%
Molina Healthcare	$27 - $245	97%
Nebraska Total Care - Wellcare	$27	97%
Ambetter / Centene	$39	141%
Oscar Health	$45	162%
Beshp	$52	188%
Midland'S Choice	$52	188%
Nebraska Total Care	$62 - $245	224%
Medica Chi Aco	$112 - $446	404%
Medica Choice National	$112 - $446	404%
Medica Ifb Aco	$118 - $470	426%
Medica Ifb Open Access	$118 - $470	426%

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 $307.
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 Howard County 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.