CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Ira Davenport Memorial Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $93
Cash Discount Price: $90
vs. Medicare Baseline: 3.35x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Ira Davenport Memorial Hospital is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.35x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$93

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: $90 (325%)

Insurance Median: $93 (335%)

Cash: $90 (325% of Medicare)

Ins. Median: $93 (335% 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 335% of the Medicare baseline (a markup of 235%). 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
Empire	$16	58%
Blue Cross Blue Shield	$26 - $453	94%
Humana	$26 - $134	94%
Tricare	$26	94%
Amerihealth Caritas Mcr Adv - All Plans	$27	97%
Fidelis	$37 - $66	133%
Fidelis Care - Exchange - All Plans	$82	296%
Geisinger - All Plans	$87	314%
Cigna	$93	335%
Mvp Health Plan - All Plans	$93	335%
Independent Health - All Plans	$97	350%
Upmc - All Plans	$103	372%
Pomco Inc - All Plans	$108	390%
Aetna	$112 - $133	404%
UnitedHealthcare	$112 - $157	404%
Emblem Health - All Plans	$131	473%
Emblem/Ghi	$138	498%
Martins Point - All Plans	$149	538%
Healthnow - All Plans	$492	1775%

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 $90.
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 Ira Davenport 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.