CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Montefiore New Rochelle Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $77
Cash Discount Price: $116
vs. Medicare Baseline: 2.78x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Montefiore New Rochelle Hospital is $77. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.78x the Medicare baseline. Located in 16 Guion Place, New Rochelle, NY.

Cash / Self-Pay

$116

Average discount available for prompt cash payment at this facility.

Insurance Median

$77

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: $116 (418%)

Insurance Median: $77 (278%)

Cash: $116 (418% of Medicare)

Ins. Median: $77 (278% 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 278% of the Medicare baseline (a markup of 178%). 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
UnitedHealthcare	$28 - $77	101%
Emblem	$30 - $249	108%
Empire	$30 - $154	108%
Fidelis	$30 - $92	108%
Healthfirst	$30	108%
Metroplus	$30 - $138	108%
Villagecaremax	$30	108%
Vnsny Choice	$30 - $88	108%
Wellcare	$31 - $78	112%
Amidacare	$32 - $77	115%
Partners_Health_Plan	$32	115%
Hamaspik	$33 - $81	119%
Humana	$33	119%
Molina Healthcare Of Ny Affinity	$42 - $170	152%
Medicaid / KanCare	$77	278%
Mvp	$77 - $176	278%
Vnsny Select Health	$88	317%
Oscar	$121	437%
Cigna	$278 - $294	1003%
Aetna	$300 - $336	1082%
Northwell	$364	1313%

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 $116.
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 Montefiore New Rochelle 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.