CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Albany Medical Center Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $43
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Albany Medical Center Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.55x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $87 (314%)
Insurance Median: $43 (155%)
Cash: $87 (314% of Medicare)
Ins. Median: $43 (155% 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.

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
Aetna $10 - $260 36%
UnitedHealthcare $16 - $201 58%
Cdphp $18 - $214 65%
Medicare (plans) $20 - $29 72%
Fidelis $21 - $214 76%
Blue Cross Blue Shield $22 - $214 79%
Blue Shield Highmark $22 - $56 79%
Tricare $22 - $26 79%
Hamaspik $25 - $223 90%
Mvp $25 - $95 90%
Nascentia Health Options $27 - $138 97%
Blue Shield $28 - $283 101%
Emblem $29 - $269 105%
Emblem Health Ghi $29 - $57 105%
Nascentia $29 105%
Cigna $39 - $48 141%
Empire Plan Nyship $39 - $201 141%
Magnacare $39 - $201 141%
Multiplan $41 - $213 148%
Nys Department Of Corrections $62 224%
Emblem_Ghi $64 - $358 231%
Mvp Commercial $89 - $296 321%
Mvp Essential Plan $204 736%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43 New Scotland Avenue, Mail Code 34, Albany, NY 12208
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals