CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $170
  • Cash Discount Price: $432
  • vs. Medicare Baseline: 6.13x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Hospital of Univ of Pennsylvania is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $432. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 6.13x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$432

Average discount available for prompt cash payment at this facility.

Insurance Median
$170

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: $432 (1558%)
Insurance Median: $170 (613%)
Cash: $432 (1558% of Medicare)
Ins. Median: $170 (613% 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 613% of the Medicare baseline (a markup of 513%). 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
Gspp And Wissahickon Hospice $14 51%
Health Partners $18 - $432 65%
UnitedHealthcare $25 - $432 90%
Blue Cross Blue Shield $28 - $264 101%
Kaiser Permanente $28 - $432 101%
Medicare (plans) $28 - $29 101%
Philadelphia Va Medical Center $28 101%
Tricare $28 101%
Upmc $28 - $432 101%
Us Family Health Plan $28 101%
Cigna $29 - $194 105%
Geisinger Health Plan $29 - $90 105%
Humana $29 - $346 105%
Ibc $29 105%
Aetna $30 - $432 108%
Devoted Health $30 108%
Pa Health And Wellness $30 - $47 108%
Penn Life (Living Independently For Elders) $30 108%
Clover Health Plan $31 112%
Keystone First $31 112%
Gateway Health Plan $35 126%
Elap $40 144%
Claims Watcher $45 - $51 162%
Oscar Health Plan $48 173%
Centivo $51 184%
Elap Services $53 191%
Highmark $59 213%
Paired Kidney Exchange $69 249%
Horizon Nj Health $73 - $76 263%
Penn Global Medicine $75 271%
Keystone Mercy Health Plan $86 - $432 310%
Preferred Health Care Eliance $95 343%
Pgm - Regie De L'Assurance Maladie Quebec $99 357%
Ibc Commercial Hpn $103 372%
Keystone Hmo Proactive $105 379%
Pgm - Kuwait Defense $151 - $194 545%
Qualcare $164 592%
Olympus $170 613%
Coventry $173 - $220 624%
Medicaid / KanCare $173 - $432 624%
Pgm - Chop $173 624%
Wissahickon Hospice $173 624%
Healthamerica/Coventry $194 - $212 700%
First Health Global $216 779%
Health Net $259 934%
Pgm - Royal Embassy Of Saudi Arabia $259 934%
Pgm - Embassy Of Qatar $281 1014%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $281 1014%
Interlink $289 1043%
Pgm - Embassy Of The United Emirates/Ipc $302 1089%
Health America/Ccn $346 1248%
Intergroup $346 1248%
Pgm - Kuwait Health Division $346 1248%
Pgm - Kuwait Oil $346 1248%
Preferred Care $346 1248%
Blue Quality Centers For Transplant (Bqct) $432 1558%
City Of Philadelphia Behavioral Health $432 1558%
Commercial Other $432 1558%
International Pfs $432 1558%
Pa Medical Assistance $432 1558%
United Behavioral Health $432 1558%
Workers Compensation $432 1558%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals