CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: NYU Langone Hospitals

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $253
Cash Discount Price: $70
vs. Medicare Baseline: 9.13x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at NYU Langone Hospitals is $253. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 9.13x the Medicare baseline. Located in 550 First Avenue, New York, NY.

Cash / Self-Pay

$70

Average discount available for prompt cash payment at this facility.

Insurance Median

$253

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: $70 (253%)

Insurance Median: $253 (913%)

Cash: $70 (253% of Medicare)

Ins. Median: $253 (913% 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 913% of the Medicare baseline (a markup of 813%). 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
Fidelis	$28 - $256	101%
Healthfirst	$28 - $256	101%
Healthplus	$28 - $256	101%
Ghi	$30 - $360	108%
Hip	$30 - $360	108%
Medicare (plans)	$30 - $31	108%
Wellcare	$30 - $31	108%
Amida	$31	112%
Centerlight	$31 - $32	112%
Metroplus	$43 - $256	155%
Hamaspik	$46	166%
1199	$50	180%
Medicaid / KanCare	$70 - $114	253%
UnitedHealthcare	$70 - $381	253%
Somos	$73 - $154	263%
Blue Cross Blue Shield	$202 - $253	729%
Oscar	$239	862%
Multiplan	$285	1028%
Oxford	$308 - $358	1111%
Aetna	$313 - $366	1129%
Magnacare	$370 - $596	1335%
Cigna	$393	1418%

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 $70.
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 NYU Langone Hospitals 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.