CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Rainbow Babies and Childrens Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $106
  • Cash Discount Price: $126
  • vs. Medicare Baseline: 3.82x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Rainbow Babies and Childrens Hospital is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.82x the Medicare baseline. Located in 11100 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$126

Average discount available for prompt cash payment at this facility.

Insurance Median
$106

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: $126 (455%)
Insurance Median: $106 (382%)
Cash: $126 (455% of Medicare)
Ins. Median: $106 (382% 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 382% of the Medicare baseline (a markup of 282%). 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
Aetna $26 - $134 94%
Blue Cross Blue Shield $26 - $109 94%
Cigna $26 - $108 94%
Devoted Health $26 94%
Humana $26 94%
Medical Mutual Of Ohio $26 - $133 94%
Molina $26 94%
Primetime Health Plan $26 94%
Summacare $26 - $123 94%
The Health Plan $26 - $118 94%
UnitedHealthcare $26 - $118 94%
Wellcare By Allwell $26 94%
Paramount $27 97%
Perennial Advantage Of Ohio $27 97%
Valor Health Plans $27 97%
University Health Employee Plan (Contigo) $56 - $84 202%
Amish Aid Community Plan $84 303%
Amish Church Fund And Workers Aid Plan $84 303%
Buckeye Plain Ministries $84 303%
Christian Healthcare Ministries $84 303%
Sunrise Plain Communities $84 303%
Caresource $91 328%
Ambetter / Centene $94 339%
Jp Farley $94 - $101 339%
Immergrun $101 364%
Aultcare $106 - $111 382%
Healthsmart $109 393%
Ohio Health Choice $109 - $151 393%
Health Ohio Network $113 408%
Clarity $118 426%
Enterprise Group Planning $118 426%
Medical Mutual Traditional/Health Ohio $118 426%
Beech Street $134 - $151 483%
Ohio Preferred Network $134 - $151 483%
Century Health Network $143 516%
First Health $143 516%
Private Healthcare System $144 519%
Configurenet $151 545%
Fortified Provider Network $151 545%
Multiplan $151 545%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11100 Euclid Avenue, Cleveland, OH 44106
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens