CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Carlsbad Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $230
  • Cash Discount Price: $67
  • vs. Medicare Baseline: 8.30x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Carlsbad Medical Center is $230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 8.30x the Medicare baseline. Located in 2430 West Pierce Street, Carlsbad, NM.
Cash / Self-Pay
$67

Average discount available for prompt cash payment at this facility.

Insurance Median
$230

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: $67 (242%)
Insurance Median: $230 (830%)
Cash: $67 (242% of Medicare)
Ins. Median: $230 (830% 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 830% of the Medicare baseline (a markup of 730%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $26 - $403 94%
Department Of Veterans Affairs $26 94%
Medicare (plans) $26 94%
Node Molina Mcr Adv $26 94%
Presbyterian $26 - $322 94%
Tricare $26 94%
Veterans Eval Services $26 94%
Node Va $27 97%
Triwest $27 97%
UnitedHealthcare $27 - $295 97%
Node Choice Care Mcr Adv $28 101%
Node Devoted Health Mcr Adv $28 101%
Wexford Health $33 119%
Us Department Of Labor $40 144%
Self Pay $45 - $89 162%
Medicaid / KanCare $46 - $49 166%
Work Comp Nm $56 - $161 202%
Node Molina Health Exchange $73 263%
Nm Health Connection $107 386%
Eddy County Detention $223 804%
Capstar $245 884%
Zelis $281 - $375 1014%
Omni Network $290 1046%
Cigna $309 - $374 1115%
Choice Care $312 1126%
Ccn First Health $357 1288%
Healthsmart $361 - $384 1302%
Aetna $375 1353%
Multiplan $375 1353%
Medical Control Inc $415 1497%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2430 West Pierce Street, Carlsbad, NM 88220
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals