CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: UPMC Hamot

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $45
Cash Discount Price: $66
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at UPMC Hamot is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.62x the Medicare baseline. Located in 201 State Street, Erie, PA.

Cash / Self-Pay

$66

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $66 (238%)

Insurance Median: $45 (162%)

Cash: $66 (238% of Medicare)

Ins. Median: $45 (162% 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
Univera	$16 - $50	58%
Upmc Health Plan	$23 - $41	83%
Blue Cross Blue Shield	$24 - $117	87%
UnitedHealthcare	$24 - $139	87%
Aetna	$25 - $79	90%
Geisinger	$29	105%
Highmark Wholecare (Prev Gateway)	$31 - $56	112%
Cigna	$32 - $45	115%
Health Partners Plans (Jefferson Health Plan)	$32	115%
Amerihealth Caritas	$33	119%
Pa Health & Wellness	$36	130%
Fidelis	$38 - $84	137%
Independent Health	$46 - $51	166%
Upmc Work Partners	$47	170%
Intergroup	$70 - $90	253%
Multiplan	$75 - $90	271%
Molina Healthcare Of Ny	$84	303%

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 $66.
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 Hamot 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.