CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Licking Memorial Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $157
  • Cash Discount Price: $192
  • vs. Medicare Baseline: 5.66x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Licking Memorial Hospital is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 5.66x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$192

Average discount available for prompt cash payment at this facility.

Insurance Median
$157

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: $192 (693%)
Insurance Median: $157 (566%)
Cash: $192 (693% of Medicare)
Ins. Median: $157 (566% 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 566% of the Medicare baseline (a markup of 466%). 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 $25 90%
Aetna $26 - $159 94%
Blue Cross Blue Shield $26 - $165 94%
Champva [500001] $26 94%
Cigna $26 - $173 94%
Humana $26 - $187 94%
Medicare (plans) $26 94%
UnitedHealthcare $26 - $163 94%
Veterans Administration [100068] $26 94%
Wellcare By Allwell [450104] $26 94%
Molina Marketplace [100106] $41 148%
Medical Mutual [100114] $106 - $160 382%
Medben [700068] $135 - $188 487%
Benicomp [70090] $144 519%
Consociate Health 6 Degrees [100059] $154 556%
Consociate Health [100029] $154 556%
Allied Benefit Systems [100015] $157 566%
Geha [100039] $157 566%
Gravie Administrative Services [100165] $157 566%
Meritain [100063] $157 566%
Optima [700069] $157 566%
Trustmark Small Business Benefits [100263] $157 566%
Webtpa [100127] $157 566%
Healthscope [100157] $163 588%
Surest [100016] $163 588%
United Medical Resources [700071] $163 588%
American Postal Workers [100089] $173 624%
Antidote Health Plan Of Ohio [70006803] $173 624%
Coresource [100002] $173 - $192 624%
Great West Life [700064] $173 624%
National Association Of Letter Carriers [100067] $173 624%
Ohio Healthy Luminare Health [100264] $173 624%
Ohio Healthy [100255] $173 624%
Ohio Ppo Connect [70006801] $173 624%
Osu Prime Care [100254] $173 624%
Quality Care Partners [70006802] $173 624%
The Health Plan [100261] $173 624%
Wellfleet Group, Llc [100164] $173 624%
Coventry [100010] $177 639%
Pan American Life [700070] $177 639%
Ohio Health Choice [100109] $185 667%
Administrative Concepts [100006] $187 675%
Carefactor [100087] $187 675%
Philadelphia American Life [100260] $187 - $192 675%
Reliance Standard-Asrm [100258] $187 675%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals