CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: St Mary's Healthcare

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $41
  • Cash Discount Price: $43
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at St Mary's Healthcare is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.48x the Medicare baseline. Located in 427 Guy Park Avenue, Amsterdam, NY.
Cash / Self-Pay
$43

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $43 (155%)
Insurance Median: $41 (148%)
Cash: $43 (155% of Medicare)
Ins. Median: $41 (148% 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
Medicare (plans) $27 - $30 97%
Tricare $27 97%
Va $27 97%
Aetna $28 - $214 101%
Blue Cross Blue Shield $28 - $55 101%
Humana $28 101%
Carelon_Commercial $30 - $40 108%
Carelon_Empire $30 - $40 108%
Cdphp_Commercial $41 - $114 148%
Emblem_Commercial $44 - $59 159%
Excellus_Commercial $44 - $58 159%
Medicaid / KanCare $63 - $70 227%
UnitedHealthcare $63 227%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 427 Guy Park Avenue, Amsterdam, NY 12010
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals