CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Southern Hills Hospital and Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $80
Cash Discount Price: $360
vs. Medicare Baseline: 2.89x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Southern Hills Hospital and Medical Center is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $360. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.89x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

$360

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $360 (1299%)

Insurance Median: $80 (289%)

Cash: $360 (1299% of Medicare)

Ins. Median: $80 (289% 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 289% of the Medicare baseline (a markup of 189%). 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	$4 - $51	14%
Alignment Health Plan	$24 - $28	87%
Ambetter / Centene	$24 - $81	87%
Blue Cross Blue Shield	$24 - $28	87%
Hometown Health Mcr	$24 - $28	87%
Humana	$24 - $28	87%
Select Health	$24 - $89	87%
Triwest	$24 - $28	87%
United	$24 - $85	87%
Caremore	$25 - $28	90%
Community Care Health	$26	94%
Molina Healthcare	$26 - $27	94%
Sierra Hpn	$26	94%
Caresource	$27	97%
Health Net	$27	97%
Imperial Nv	$27 - $30	97%
Universal Healthcare	$29 - $33	105%
Prominence Healthfirst	$60 - $116	216%
Corvel	$78	281%
Olympus Medsave Usa	$82 - $291	296%
Cmn Global	$84 - $163	303%
Evernorth	$100 - $194	361%
Hometown Health Providers	$100 - $194	361%
Nv Health & Welfare Trust	$120 - $233	433%
Multiplan	$126 - $283	455%
First Health	$132 - $310	476%
Medcare International	$150 - $291	541%

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 $360.
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 Southern Hills Hospital and 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.