CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: St Catherine of Siena Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $131
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.73x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at St Catherine of Siena Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.73x the Medicare baseline. Located in 50 Route 25A, Smithtown, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$131

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%)
Insurance Median: $131 (473%)
Ins. Median: $131 (473% 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 473% of the Medicare baseline (a markup of 373%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Zadroga $45 162%
Health First $52 - $184 188%
Us Family Health Plan $60 216%
Blue Cross Blue Shield $73 - $130 263%
Centers Plan For Healthy Living $78 281%
Affinity Health Plan $82 - $184 296%
Beacon Health Options $82 - $130 296%
Beacon Health Strategies $82 - $104 296%
Centerlight Healthcare $82 296%
Elderplan Inc. $82 296%
Emblem Health $82 - $130 296%
Fidelis Care New York $82 - $184 296%
Health Plus $82 - $184 296%
Independent Health $82 296%
Medicaid / KanCare $82 296%
Mvp Health Plans $82 - $293 296%
Senior Whole Health $82 296%
UnitedHealthcare $82 - $303 296%
Self Pay $96 346%
Liberty Health $104 375%
Oscar Health $107 386%
American Plan Administrators $117 422%
Amerihealth Administrators $117 422%
Benefit Services $117 422%
Ghi Cbp Ny City Employee Alternate $117 422%
International Benefit Administrator $117 422%
Ultra Benefits Inc. $117 422%
Aetna $130 - $356 469%
Allied Wellfare Fund $170 613%
American Group Administrators $170 613%
Bakery & Confectionery Union $170 613%
Cigna $170 - $293 613%
Comprehensive Benefits Consultant $170 613%
Guardian Life Insurance Company Of America $170 613%
Maloney And Assoc $170 613%
Multiplan $170 613%
Performax $170 613%
Phcs $170 613%
Pomco $170 613%
Tpa Inc $170 613%
Unicare $170 613%
United Employees Health Plan $170 613%
Coventry $193 - $209 696%
Local 1199 $200 722%
Longevity Health Plan $209 754%
Magellan $209 754%
Galaxy $235 848%
Three Rivers Provider Network $235 848%
Aither Health $261 942%
Alpha Care $261 942%
Dentaquest $261 942%
Veterans Affairs $261 942%
Brighton $266 - $356 960%
Centivo $272 - $293 981%
Apwu $293 1057%
Daniel H Cook $293 1057%
Nalc $293 1057%
Samba $293 1057%
Surest $303 1093%
Mail Handlers Benefit Plan $356 1284%
Meritain Health $356 1284%
Nippon Life Insurance Company Of America $356 1284%
Salvation Army $356 1284%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 50 Route 25A, Smithtown, NY 11787
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals