CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Hackensack University Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $189
Cash Discount Price: $35
vs. Medicare Baseline: 6.82x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Hackensack University Medical Center is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 6.82x the Medicare baseline. Located in 30 Prospect Ave, Hackensack, NJ.

Cash / Self-Pay

$35

Average discount available for prompt cash payment at this facility.

Insurance Median

$189

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: $35 (126%)

Insurance Median: $189 (682%)

Cash: $35 (126% of Medicare)

Ins. Median: $189 (682% 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 682% of the Medicare baseline (a markup of 582%). 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
UnitedHealthcare	$28 - $406	101%
Aetna	$35 - $338	126%
Amerigroup	$35	126%
Blue Cross Blue Shield	$35	126%
Horizon	$35 - $216	126%
Vaccn	$35	126%
Wellcare	$35	126%
United Community/Americhoice	$37	133%
Clover	$40	144%
Karna	$47	170%
Seoul Medical Group	$63	227%
Intergroup	$155	559%
Lhp Health	$175	631%
Cigna	$178 - $238	642%
Activecare First McO	$189	682%
Chn	$189	682%
Multiplan - PHCS	$189	682%
Qualcare	$196	707%
Brighton Health Plan	$200	722%
Amerihealth	$222	801%
Bergen Risk	$291	1050%
Oxford	$346	1248%

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 $35.
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 Hackensack University 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.