CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Strong Memorial Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $41
Cash Discount Price: $84
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Strong Memorial Hospital is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.48x the Medicare baseline. Located in 601 Elmwood Ave, Rochester, NY.

Cash / Self-Pay

$84

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: $84 (303%)

Insurance Median: $41 (148%)

Cash: $84 (303% 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.

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
Blue Cross Blue Shield	$12 - $87	43%
Excellus [2201]	$12	43%
UnitedHealthcare	$16 - $87	58%
Highmark Bc/Bs Of Western Ny [5143]	$19 - $49	69%
Aetna	$22 - $71	79%
Excellus Bc/Bs [2201]	$22 - $48	79%
Medicaid / KanCare	$22 - $87	79%
Medicare (plans)	$22 - $30	79%
Mvp [2900]	$22 - $126	79%
Elderplan [1316]	$26	94%
Icircle [1728]	$26	94%
Martins Point [1205]	$26	94%
Molina Healthcare [5189]	$26	94%
Nascentia [1729]	$26	94%
Humana	$27 - $31	97%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$29 - $89	105%
Fidelis [5155]	$32 - $87	115%
Independent Health [5156]	$45 - $54	162%
Capital District Physicians Health Plan (Cdphp) [5149]	$60 - $90	216%
Cigna	$61 - $126	220%
Molina Healthcare [1723], Molina Healthcare [5189]	$87	314%

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 $84.
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 Strong Memorial 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.