CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Mount Carmel Dublin
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $71
- Cash Discount Price: $99
- vs. Medicare Baseline: 2.56x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Mount Carmel Dublin is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.56x the Medicare baseline. Located in 4105 Emerald Pkwy, Dublin, OH.
Cash / Self-Pay
$99
Average discount available for prompt cash payment at this facility.
Insurance Median
$71
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: $99 (357%)
Insurance Median: $71 (256%)
Cash: $99 (357% of Medicare)
Ins. Median: $71 (256% 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 256% of the Medicare baseline (a markup of 156%). 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 |
|---|---|---|
| Medicare (plans) | $23 - $28 | 83% |
| Aetna | $26 - $96 | 94% |
| Blue Cross Blue Shield | $26 - $152 | 94% |
| The Health Plan | $27 | 97% |
| UnitedHealthcare | $27 - $283 | 97% |
| Oscar | $44 | 159% |
| Medical Mutual | $49 - $70 | 177% |
| Enterprise Group Planning | $52 | 188% |
| Custom Design Benefits | $56 | 202% |
| Quality Care Partners | $60 | 216% |
| Geha | $68 - $283 | 245% |
| Gravie Admin Services | $68 | 245% |
| Healthez | $68 | 245% |
| Meritain | $68 | 245% |
| Webtpa | $68 | 245% |
| Western & Southern Financial Group | $70 | 253% |
| Access Health | $71 | 256% |
| Acclaim | $71 | 256% |
| Administrative Concepts | $71 | 256% |
| Allegeant | $71 | 256% |
| Allied Benefit Systems | $71 | 256% |
| American Family | $71 | 256% |
| American Healthcare Alliance | $71 | 256% |
| American National | $71 | 256% |
| American Republic | $71 | 256% |
| Amerihealth | $71 | 256% |
| Aultcare | $71 | 256% |
| Automated Benefit Services | $71 | 256% |
| Auxiant | $71 | 256% |
| Benefit Administrative Systems,Llc | $71 | 256% |
| Boon Chapman | $71 | 256% |
| Cam Administrative Services | $71 | 256% |
| Christian Brother Services | $71 | 256% |
| Christian Brothers Holy Cross | $71 | 256% |
| Claimchoice Adminstrators | $71 | 256% |
| Comprehensive Benefits | $71 | 256% |
| Continental Life Insurance | $71 | 256% |
| Coventry | $71 | 256% |
| Custom Benefit Administrators | $71 | 256% |
| Cypress Benefit Administrators | $71 | 256% |
| Employee Benefit Concepts | $71 | 256% |
| Employee Benefit Management | $71 | 256% |
| Forest County Potawatomi | $71 | 256% |
| Freedom Life Insurance Company | $71 | 256% |
| Group Administrators | $71 | 256% |
| Group Marketing Services | $71 | 256% |
| Group Pension Administrators | $71 | 256% |
| Guardian | $71 | 256% |
| Health America | $71 | 256% |
| Health Choices | $71 | 256% |
| Healthcare Management Admin | $71 | 256% |
| Insight | $71 | 256% |
| Intercare | $71 | 256% |
| Jfp Benefit Management | $71 | 256% |
| Jp Farley Corporation | $71 | 256% |
| Key Benefit Administrator | $71 | 256% |
| Liberty Union Life Assurance Co | $71 | 256% |
| Lucent Health | $71 | 256% |
| Luminare Health | $71 | 256% |
| Magnacare | $71 | 256% |
| Medcost | $71 | 256% |
| Mutual Health Services | $71 | 256% |
| Mutual Of Omaha | $71 | 256% |
| Ncas | $71 | 256% |
| Nippon Life Ins | $71 | 256% |
| Nova | $71 | 256% |
| Painters Union Insurance Fund | $71 | 256% |
| Physicians Mutual | $71 | 256% |
| Plumbers Local 98 Insurance Fund | $71 | 256% |
| Prairie States | $71 | 256% |
| Preferred One | $71 | 256% |
| Primary Physician Care | $71 | 256% |
| Professional Benefit Administrators | $71 | 256% |
| Secureone Preferred United Plans | $71 | 256% |
| Siho Insurance Services | $71 | 256% |
| Sisco Benefits | $71 | 256% |
| The Loomis Company | $71 | 256% |
| Trustmark Small Business Benefits | $71 | 256% |
| U Of M Health Plan | $71 | 256% |
| Unicare | $71 | 256% |
| Unified Group Services | $71 | 256% |
| Us Health And Life | $71 | 256% |
| Valenz | $71 | 256% |
| Varipro | $71 | 256% |
| Wps | $71 | 256% |
| Humana | $78 - $152 | 281% |
| First Health | $80 | 289% |
| Paramount Hmo | $80 | 289% |
| Medben | $91 - $114 | 328% |
| Consociate | $93 | 335% |
| Health Ohio Network | $93 | 335% |
| Rural Carrier Health Benefit Plan | $96 | 346% |
| Healthlink Inc | $114 | 411% |
| Medical Benefits Mutual | $114 | 411% |
| Ohio Health Choice | $114 | 411% |
| Ohio Ppo Connect | $114 | 411% |
| Medi Share | $121 | 437% |
| Multiplan | $121 | 437% |
| Phcs | $121 | 437% |
| Philadelphia American Life Insurance | $121 | 437% |
| Ameriben | $122 | 440% |
| Luminare Health (Detroit) | $122 | 440% |
| Ohiohealthy | $122 | 440% |
| Osu Not Independent Choice | $122 | 440% |
| Twin Valley Psychiatric | $122 | 440% |
| Health Smart | $129 | 465% |
| Medicaid / KanCare | $152 | 548% |
| American Postal Workers Secondary | $232 | 837% |
| Cigna | $232 | 837% |
| Health Partners | $232 | 837% |
| Healthgram | $232 | 837% |
| Mvp | $232 | 837% |
| Priority Health | $232 | 837% |