CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Lancaster General Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $116
  • Cash Discount Price: $138
  • vs. Medicare Baseline: 4.18x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Lancaster General Hospital is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $138. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.18x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$138

Average discount available for prompt cash payment at this facility.

Insurance Median
$116

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: $138 (498%)
Insurance Median: $116 (418%)
Cash: $138 (498% of Medicare)
Ins. Median: $116 (418% 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 418% of the Medicare baseline (a markup of 318%). 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
Medicaid / KanCare $18 - $57 65%
Blue Cross Blue Shield $20 - $405 72%
UnitedHealthcare $23 - $121 83%
Tricare $24 87%
Aetna $26 - $96 94%
Albright Life $26 94%
Coatesville Va $26 94%
Highmark $26 - $142 94%
Hospice And Community Care $26 - $27 94%
Hospice Generic $26 94%
Lebanon Veterans Hospital $26 94%
Medicare (plans) $26 - $29 94%
Amerihealth Caritas $27 97%
Cigna $27 - $119 97%
Health Partners Mcr Advantage $27 97%
Devoted Health $28 101%
Pa Health And Wellness Mcr $28 101%
Upmc For You $34 - $36 123%
Elap Employees $37 133%
Old Order Group $37 - $45 133%
Lg Coresource/Lg Eliance $39 - $40 141%
Lancashire Hall $41 - $142 148%
Nursing Home Op Services $41 - $43 148%
Oscar Health Plan $51 184%
Affilia Home Health $54 - $142 195%
Masonic Homes $57 - $142 206%
Gateway $68 - $71 245%
Claim Watcher Plus $79 285%
Claim Watcher $86 310%
Eliance Health Solutions $87 - $91 314%
Highmark Commercial Preferred $91 - $142 328%
Elap Other Groups $95 343%
Ehp $112 - $116 404%
Upmc Commercial $112 - $121 404%
Devon $116 - $121 418%
Geisinger Commercial $116 - $121 418%
Intergroup Services $116 - $121 418%
Preferred Healthcare $116 - $121 418%
Medi-Share Christian Care $129 - $135 465%
Commercial Generic $136 - $142 491%
Highmark Commercial Non-Preferred $136 - $143 491%
Magellan $136 - $142 491%
United Behavioral Health $136 - $142 491%
Value Options $136 - $142 491%
Workers Compensation $136 - $142 491%
Gift Of Life Donor Program $13,500 48701%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals