CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Jfk University Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $188
Cash Discount Price: $35
vs. Medicare Baseline: 6.78x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Jfk University Medical Center is $188. 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 6.78x the Medicare baseline. Located in 65 James Street, Edison, NJ.

Cash / Self-Pay

$35

Average discount available for prompt cash payment at this facility.

Insurance Median

$188

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: $188 (678%)

Cash: $35 (126% of Medicare)

Ins. Median: $188 (678% 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 678% of the Medicare baseline (a markup of 578%). 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	$35 - $188	126%
Amerigroup	$35 - $48	126%
Blue Cross Blue Shield	$35 - $104	126%
Horizon	$35 - $206	126%
Vaccn	$35	126%
United Community/Americhoice	$37	133%
UnitedHealthcare	$38 - $558	137%
Clover	$40	144%
Karna	$47	170%
Seoul Medical Group	$48	173%
Cigna	$111 - $214	400%
Horizon - Jri@Oumc	$116 - $205	418%
Activecare First McO	$155	559%
Intergroup	$155	559%
Prime Health	$178	642%
Multiplan - PHCS	$189	682%
Oxford - Jri@Oumc	$193	696%
Qualcare	$206 - $300	743%
Amerihealth	$210 - $220	758%
Wellcare	$224	808%
Bergen Risk	$291	1050%
Brighton Health Plan	$355 - $525	1281%
Oxford	$414 - $428	1494%
Brighton Health Plan - Jri@Oumc	$500	1804%

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 Jfk 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.