CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Wooster Community Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $109
  • Cash Discount Price: $136
  • vs. Medicare Baseline: 3.93x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Wooster Community Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.93x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$136

Average discount available for prompt cash payment at this facility.

Insurance Median
$109

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: $136 (491%)
Insurance Median: $109 (393%)
Cash: $136 (491% of Medicare)
Ins. Median: $109 (393% 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 393% of the Medicare baseline (a markup of 293%). 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
Tricare $26 94%
Blue Cross Blue Shield $27 - $125 97%
Buckeye Mcare $27 97%
Caresource Mcr Adv $27 97%
Humana $27 - $128 97%
Med Mutual Of Oh Mcr $27 97%
Molina Mcr $27 97%
Summacare Mcr $27 97%
The Health Plan Mcr Adv $27 97%
UnitedHealthcare $27 - $129 97%
Valor Hp Mcr-All Plans $27 97%
Magnipower-All Plans $35 126%
Caresource Exch - All Other Plans $38 137%
Molina Marketplace - All Other Plans $45 162%
Clarity Health - All Plans $52 188%
Aultcare/Primecare Mcr Adv $67 242%
Buckeye Mcaid-All Other Plans $74 267%
Caresource Mcaid $74 267%
Molina Mcaid $76 274%
Aetna $78 - $136 281%
Amerihealth Mcaid-All Plans $78 281%
Cerco-All Plans $95 343%
Aultcare Wayne County $102 368%
Aultcare/Primetime Exch $102 368%
Rayco-All Plans $102 368%
Christian Health Ministries-All Plans $109 393%
Cigna $109 393%
Health Ohio Network Employer $109 393%
Wayne County-All Plans $109 393%
Healthsmart Accel $113 408%
Summacare Preferred Choice $113 408%
Health Ohio Network Ppo-All Other Plans $116 418%
Healthsmart Complete Ppo-All Other Plans $116 418%
Ohio Health Choice Supp $116 418%
Ohio Health Group Hlthy - All Other Plans $116 418%
Med Mutual Of Oh Exchange $117 422%
Med Mutual Of Oh Supermed $117 422%
Med Mutual Of Oh Trad-All Other Plans $117 422%
Health Plan Of Upper Ohio-All Plans $120 433%
The Health Plan Comm - All Other Plans $120 433%
Ohio Health Group Pref $121 437%
Aultcare/Primetime-All Other Plans $123 444%
Healthsmart Ppo $124 447%
Summacare-All Other Plans $127 458%
Ohio Health Choice-All Other Plans $128 462%
Healthsmart Hpo $129 465%
Osu-All Plans $129 465%
Central Benefits-All Plans $131 473%
First Health-All Plans $131 473%
Flora-All Plans $131 473%
Beech Street-All Plans $132 476%
Phcs-All Plans $132 476%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals