CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: UPMC Jameson

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $52
Cash Discount Price: $62
vs. Medicare Baseline: 1.88x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at UPMC Jameson is $52. 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 1.88x the Medicare baseline. Located in 1211 Wilmington Avenue, New Castle, PA.

Cash / Self-Pay

$62

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $52 (188%)

Cash: $62 (224% of Medicare)

Ins. Median: $52 (188% 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
Aetna	$19 - $24	69%
Upmc Health Plan	$23 - $85	83%
UnitedHealthcare	$24 - $172	87%
Blue Cross Blue Shield	$25	90%
Amerihealth Caritas	$27	97%
Geisinger	$29	105%
Pa Health & Wellness	$36	130%
Upmc Work Partners	$41	148%
Highmark Wholecare (Prev Gateway)	$52	188%
Multiplan	$78 - $83	281%
Humana	$83	299%
Occunet	$85	307%
National Provider Network	$92	332%
Cigna	$146	527%

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 $62.
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 UPMC Jameson 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.