CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Westchester Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $274
Cash Discount Price: $119
vs. Medicare Baseline: 9.88x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Westchester Medical Center is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 9.88x the Medicare baseline. Located in 100 Woods Rd, Valhalla, NY.

Cash / Self-Pay

$119

Average discount available for prompt cash payment at this facility.

Insurance Median

$274

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: $119 (429%)

Insurance Median: $274 (988%)

Cash: $119 (429% of Medicare)

Ins. Median: $274 (988% 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 988% of the Medicare baseline (a markup of 888%). 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
Cdphp	$62 - $67	224%
Mvp	$92 - $109	332%
Blue Cross Blue Shield	$98 - $180	354%
UnitedHealthcare	$183 - $274	660%
Oxford	$194 - $274	700%
Magnacare	$311 - $482	1122%
Emblem	$320 - $377	1154%
Cigna	$330	1190%
Aetna	$338 - $378	1219%

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 $119.
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 Westchester 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.