CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Adventist Health Portland

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $104
  • Cash Discount Price: $58
  • vs. Medicare Baseline: 3.75x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Adventist Health Portland is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.75x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$58

Average discount available for prompt cash payment at this facility.

Insurance Median
$104

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: $58 (209%)
Insurance Median: $104 (375%)
Cash: $58 (209% of Medicare)
Ins. Median: $104 (375% 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 375% of the Medicare baseline (a markup of 275%). 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
Ods - All Plans $23 83%
Care Oregon - All Plans $25 90%
Kaiser Mcr Adv $29 105%
Humana $30 - $31 108%
Moda Mcr Adv $31 112%
UnitedHealthcare $31 - $109 112%
Healthnet Mcr Adv $34 123%
Ah Employee Health Plan - All Plans $53 191%
Moda Conn Oebb/Syn Pebb $59 213%
Workers Comp $63 227%
Moda Affinity - All Other Plans $67 242%
Kaiser - All Other Plans $76 274%
Regence Ohsu Plus $80 289%
Regence - All Other Plans $88 317%
Bc Premera First - All Plans $91 328%
Moda Select $92 332%
Healthnet Epo/Pos/Ppo $104 375%
Healthnet Hmo/Pos - All Other Plans $104 375%
Moda Connexus $104 375%
Worldventure - All Plans $109 393%
Moda Synergy $110 397%
Providence Hp - All Plans $118 426%
Regence Preferred Mcr Adv $119 429%
Pacific Source Comm - All Plans $120 433%
Cigna $123 444%
First Choice - All Plans $126 455%
Multiplan - All Plans $136 491%
Phcs - All Plans $136 491%
Regence Mcr Adv $138 498%
Aetna $140 505%
First Health-Coventry - All Plans $146 527%
National Provider Network - All Plans $160 577%
Health Payors Organization Ltd- All Plans $164 592%
Healthcare Resources - All Plans $205 740%
Moda Ohsu Ppo/Epo/Hmc $328 1183%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals