CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $29
- Cash Discount Price: $62
- vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Saint Alphonsus Medical Center Ontario is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.05x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$62
Average discount available for prompt cash payment at this facility.
Insurance Median
$29
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: $62 (224%)
Insurance Median: $29 (105%)
Cash: $62 (224% of Medicare)
Ins. Median: $29 (105% 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $16 - $28 | 58% |
| Blue Cross Blue Shield | $27 - $81 | 97% |
| Medicare (plans) | $27 - $29 | 97% |
| UnitedHealthcare | $27 - $91 | 97% |
| Ada County Jail Inmate Ins | $28 | 101% |
| Aetna | $28 - $90 | 101% |
| Ambetter / Centene | $28 | 101% |
| American Health Advantage Of Idaho | $28 | 101% |
| Amish Mennonite | $28 | 101% |
| Bcccp-Michigan | $28 | 101% |
| Bccp | $28 | 101% |
| Bmc Healthnet | $28 | 101% |
| Breast Grant-Connecticut | $28 | 101% |
| California Health And Wellness | $28 | 101% |
| Cardinal Innovations Lme | $28 | 101% |
| Care Oregon Ohp | $28 | 101% |
| Cencal Health Plan | $28 | 101% |
| Cenpatico | $28 | 101% |
| Centurion Of Idaho | $28 | 101% |
| Chhuny | $28 | 101% |
| Childrens Comm Health Plan | $28 | 101% |
| Childrens Medical Services Title 19 | $28 | 101% |
| Cigna | $28 - $89 | 101% |
| Community Benefit Health | $28 | 101% |
| Community Care Behavorial Health | $28 | 101% |
| Community Health Choice | $28 | 101% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $28 | 101% |
| Dean Wi Badgercare | $28 | 101% |
| Delaware First Health | $28 | 101% |
| Delta Dental Nj | $28 | 101% |
| Dph Tb Program | $28 | 101% |
| Dscc | $28 | 101% |
| Eastpointe Lme | $28 | 101% |
| Family Health Network | $28 | 101% |
| Freedom First Healthcare | $28 | 101% |
| Ghc Scw Wi Badgercare | $28 | 101% |
| Harbor Health | $28 | 101% |
| Health Safety Net | $28 | 101% |
| Healthy Blue Ne | $28 | 101% |
| Hennepin Health | $28 | 101% |
| Humana | $28 - $84 | 101% |
| Id County Ada | $28 | 101% |
| Id County Canyon | $28 | 101% |
| Id County Cat Fund | $28 | 101% |
| Id County Payette | $28 | 101% |
| Idaho Womens Health Check | $28 | 101% |
| Indiana Breast Cervical Cancer | $28 | 101% |
| Inland Empire Health Plan | $28 | 101% |
| Intercommunity Health Ohp | $28 | 101% |
| Iowa Total Care | $28 | 101% |
| Jai Medical System | $28 | 101% |
| Kern Family Health Plan | $28 | 101% |
| Keystone First | $28 | 101% |
| Keystone First Chip | $28 | 101% |
| La Care Health Plan | $28 | 101% |
| Lakeland Care Inc | $28 | 101% |
| Managed Health Services - Indiana | $28 | 101% |
| Maryland Breast & Cervical Program | $28 | 101% |
| Maryland Healthy Smiles - Scion Dental | $28 | 101% |
| Maryland Physicians Care | $28 | 101% |
| Massachusetts Behavioral Health Partnership | $28 | 101% |
| Mdwise | $28 | 101% |
| Medi-Cal | $28 | 101% |
| Medi-Cal Healthnet | $28 | 101% |
| Medstar Dc Healthy Family | $28 | 101% |
| Medstar Md Health Choice | $28 | 101% |
| Mo Home State Health Plan | $28 | 101% |
| Molina Centennial Care | $28 | 101% |
| Nascentia Health Options | $28 | 101% |
| Nebraska Total Care | $28 | 101% |
| New York Cancer Services Program | $28 | 101% |
| Nextlevel Health | $28 | 101% |
| Oregon Screenwise | $28 | 101% |
| Pace Of Southwest Michigan | $28 | 101% |
| Paramount Advantage | $28 | 101% |
| Parkland Community Health Plan | $28 | 101% |
| Partners Behavioral Lme | $28 | 101% |
| Peach State Healthplan | $28 | 101% |
| Presbyterian Centennial Care | $28 | 101% |
| Prestige Health Choice | $28 | 101% |
| Priority Partners | $28 | 101% |
| Rx 340B Pass Along | $28 | 101% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $28 | 101% |
| Rx Medi-Cal | $28 | 101% |
| Rx Meridian Rx | $28 | 101% |
| Sandhills Center Lme | $28 | 101% |
| Screening For Life | $28 | 101% |
| Sunshine State Health Plan | $28 | 101% |
| Superior Health | $28 | 101% |
| Tenncare | $28 | 101% |
| Texas Children'S Health Plan | $28 | 101% |
| Trillium Community Ohp | $28 | 101% |
| Tufts Health Public Plans | $28 | 101% |
| Vaya Health Lme | $28 | 101% |
| Wellsense Health Plan | $28 | 101% |
| Wi Womens Wellness | $28 | 101% |
| Blue Benefit Administrators Of Massachusetts | $42 | 152% |
| Blue Care Network | $42 | 152% |
| Blue Distinction Transplant | $42 | 152% |
| Blue Shield - Ca | $42 | 152% |
| Blue Shield - Id (Regence) | $42 | 152% |
| Blue Shield - Ny Highmark Northeastern | $42 | 152% |
| Blue Shield - Ny Highmark Western | $42 | 152% |
| Blue Shield - Pa (Highmark) | $42 | 152% |
| Blue Shield - Wa (Regence) | $42 | 152% |
| Healthcare Management Admin | $45 | 162% |
| Moda Health | $52 - $92 | 188% |
| Selecthealth | $53 - $86 | 191% |
| Mountain Health Co-Op | $57 | 206% |
| Pacificsource Health Plans | $57 - $89 | 206% |
| Allegiance | $72 | 260% |
| Webtpa | $73 - $86 | 263% |
| Correctional Health Partners | $74 | 267% |
| Columbia Health Network | $76 | 274% |
| Healthnet | $80 | 289% |
| Allied National Global Care | $86 | 310% |
| Asrm - Reliance Standard Life Insurance | $86 | 310% |
| Christian Care Ministry | $86 | 310% |
| Dean Health | $86 | 310% |
| Fallon Health | $86 | 310% |
| Family Life Insurance Company | $86 | 310% |
| First Choice Health | $86 | 310% |
| Ghc Scw | $86 | 310% |
| International Benefit Administrators | $86 | 310% |
| Lifetime Benefit Solutions | $86 | 310% |
| Manhattan Life | $86 | 310% |
| Pai | $86 | 310% |
| Pan-American Life | $86 | 310% |
| Paramount Hmo | $86 | 310% |
| Phcs | $86 | 310% |
| Trinity Health Share | $86 | 310% |
| Lifewise | $88 | 317% |
| Priority Health | $89 | 321% |
| Allied Benefit Systems | $90 | 325% |
| Ameriben | $90 | 325% |
| Asr Health Benefits | $90 | 325% |
| Christian Brother Services | $90 | 325% |
| First Health | $90 | 325% |
| Geha | $90 - $91 | 325% |
| Healthez | $90 | 325% |
| Luminare Health (Detroit) | $90 | 325% |
| Medi Share | $90 | 325% |
| Providence | $90 | 325% |
| Rural Carrier Health Benefit Plan | $90 | 325% |