CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Maimonides Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $27
Cash Discount Price: $134
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Maimonides Medical Center is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 0.97x the Medicare baseline. Located in 4802 Tenth Avenue, Brooklyn, NY.

Cash / Self-Pay

$134

Average discount available for prompt cash payment at this facility.

Insurance Median

$27

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: $134 (483%)

Insurance Median: $27 (97%)

Cash: $134 (483% of Medicare)

Ins. Median: $27 (97% 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.

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
Healthfirst	$4 - $31	14%
Aetna	$14 - $47	51%
Emblem Health - Ghi	$15 - $95	54%
UnitedHealthcare	$15 - $23	54%
Blue Cross Blue Shield	$18 - $121	65%
Fidelis	$19 - $56	69%
Oxford Health Plan	$23	83%
Villagecare Maxx Fida	$23	83%
Emblem Health - Hip	$26	94%
Oxford Liberty	$26	94%
Metroplus	$30 - $38	108%
United Community Plan	$35	126%
Centivo	$50	180%
Local 1199	$50	180%

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 $134.
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 Maimonides 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.