CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Artesia General Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $162
Cash Discount Price: $122
vs. Medicare Baseline: 5.84x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Artesia General Hospital is $162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 5.84x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$122

Average discount available for prompt cash payment at this facility.

Insurance Median

$162

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: $122 (440%)

Insurance Median: $162 (584%)

Cash: $122 (440% of Medicare)

Ins. Median: $162 (584% 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 584% of the Medicare baseline (a markup of 484%). 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
Zelis	$36 - $218	130%
Blue Cross Blue Shield	$45 - $262	162%
Humana	$45 - $113	162%
Molina Healthcare Of New Mexico	$46	166%
Presbyterian Health Plan	$46 - $53	166%
UnitedHealthcare	$46 - $371	166%
First Health	$52 - $392	188%
New Mexico Health Connections	$104 - $262	375%
Geha	$122 - $349	440%
Omni Networks	$122 - $305	440%
Three Rivers Provider Network	$130 - $327	469%
Cigna	$148 - $392	534%
Triwest	$153 - $384	552%
Galaxy Health	$157 - $392	566%
One Health Plan	$157 - $392	566%
Multiplan	$158 - $397	570%
United Payors & United Providers	$162 - $405	584%
Providence Risk & Insurance Services	$165 - $414	595%

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 $122.
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 Artesia General Hospital 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.