CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Children's Nebraska

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $116
Cash Discount Price: Unavailable
vs. Medicare Baseline: 4.18x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Children's Nebraska is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.18x the Medicare baseline. Located in 8200 Dodge St, Omaha, NE.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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%)

Insurance Median: $116 (418%)

Ins. Median: $116 (418% 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 418% of the Medicare baseline (a markup of 318%). 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
Medicaid / KanCare	$23 - $90	83%
Wellpoint	$23	83%
Molina (Iowa)	$24	87%
Aetna	$35 - $187	126%
Ambetter / Centene	$71 - $148	256%
Midlands Choice Chi	$84 - $148	303%
Blue Cross Blue Shield	$86 - $170	310%
Molina (Nebraska)	$94	339%
Midlands Choice Elevate	$96 - $170	346%
Avera Health Plan	$102 - $180	368%
Centivo	$102 - $180	368%
Wellmark	$102 - $180	368%
Midlands Choice	$106 - $187	382%
Sanford Health Plan	$106 - $187	382%
UnitedHealthcare	$116 - $129	418%

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 $X.
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 Children's Nebraska 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.