CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Highland District Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $55
Cash Discount Price: $121
vs. Medicare Baseline: 1.98x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Highland District Hospital is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.98x the Medicare baseline. Located in 1275 North High Street, Hillsboro, OH.

Cash / Self-Pay

$121

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

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: $121 (437%)

Insurance Median: $55 (198%)

Cash: $121 (437% of Medicare)

Ins. Median: $55 (198% 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.

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
Blue Cross Blue Shield	$48 - $115	173%
Humana	$48 - $134	173%
Medicare (plans)	$48 - $50	173%
UnitedHealthcare	$48	173%
Aetna	$49 - $123	177%
Medigold	$51	184%
Highland_County_Sheriff_Dept	$52	188%
Medicaid / KanCare	$52 - $55	188%
Immergrun_Amish	$121	437%
Medben	$121	437%
Central_Benefits_Commercial	$136	491%
Cigna	$136	491%
Medical_Mutual_Commercial	$137	494%
Uhc_	$139	501%

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 $121.
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 Highland District 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.