CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Fostoria Community Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $119
Cash Discount Price: $137
vs. Medicare Baseline: 4.29x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Fostoria Community Hospital is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $137. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.29x the Medicare baseline. Located in 501 Van Buren Street, Fostoria, OH.

Cash / Self-Pay

$137

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

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: $137 (494%)

Insurance Median: $119 (429%)

Cash: $137 (494% of Medicare)

Ins. Median: $119 (429% 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 429% of the Medicare baseline (a markup of 329%). 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
Meridian Health Plan Of Mi	$14	51%
Buckeye Community Health Plan	$16 - $126	58%
Dayton Area Health Plan Dba Caresource	$16 - $124	58%
UnitedHealthcare	$17 - $126	61%
Blue Cross Blue Shield	$26 - $137	94%
Health Alliance Plan	$26 - $158	94%
Health Value Management	$26 - $46	94%
Paramount Health Care	$26 - $112	94%
Aetna	$30 - $141	108%
Buckeye Community Health Plan Inc	$30 - $77	108%
Veterans Affairs	$46	166%
Medical Mutual Of Ohio	$119 - $127	429%
Frontpath Health Coalition	$122	440%
Amerihealth	$131	473%
Ohio Health Choice	$137	494%
Ohio Ppo Connect	$137 - $158	494%
Health Ohio Network	$167	602%
Connecticut General Life Insurance Company	$168	606%

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 $137.
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 Fostoria Community 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.