CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Cape Regional Medical Center Inc

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $130
Cash Discount Price: $40
vs. Medicare Baseline: 4.69x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Cape Regional Medical Center Inc is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.69x the Medicare baseline. Located in Two Stone Harbor Blvd, Cape May Court House, NJ.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

$130

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: $40 (144%)

Insurance Median: $130 (469%)

Cash: $40 (144% of Medicare)

Ins. Median: $130 (469% 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 469% of the Medicare baseline (a markup of 369%). 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
Aetna	$25 - $159	90%
Americhoice	$25 - $36	90%
Amerigroup	$26 - $28	94%
Clover Health	$36	130%
Partners Direct Health	$57	206%
Horizon Nj Health	$60	216%
Cigna	$119 - $132	429%
Blue Cross Blue Shield	$125 - $138	451%
Qualcare	$132 - $224	476%
Horizon Casualty Motor Vehicle	$155 - $165	559%
Horizon Casualty Workers Comp	$155 - $165	559%
Amerihealth	$160 - $170	577%
UnitedHealthcare	$172 - $209	620%

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 $40.
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 Cape Regional Medical Center Inc 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.