CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $60
  • Cash Discount Price: $148
  • vs. Medicare Baseline: 2.16x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Independence Health System Butler Memorial Hospita is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $148. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.16x the Medicare baseline. Located in One Hospital Way, Butler, PA.
Cash / Self-Pay
$148

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $148 (534%)
Insurance Median: $60 (216%)
Cash: $148 (534% of Medicare)
Ins. Median: $60 (216% 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 216% of the Medicare baseline (a markup of 116%). 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
Upmc $15 - $222 54%
Highmark $26 - $55 94%
Life Butler County $26 94%
Martin'S Point - Usfhp $26 - $74 94%
Medicare (plans) $26 94%
Peak Health $26 - $148 94%
Provider Partners $26 94%
Tricare $26 94%
UnitedHealthcare $26 - $29 94%
Aetna $27 - $169 97%
Humana $27 97%
Amerihealth $28 101%
Devoted Health Plan $28 - $84 101%
Gateway $28 - $222 101%
Geisinger $28 - $211 101%
Pa Health & Wellness $28 101%
The Health Plan $28 - $62 101%
American Health Plan $29 105%
Pnoa $29 - $169 105%
Highmark Aca - Direct Blue $35 - $39 126%
Highmark - Ind.& Managed Care $39 - $61 141%
Highmark Community Blue $39 - $54 141%
Workers Comp $49 177%
Ellwood Group $52 - $91 188%
Ccbh - Behavioral Health $60 - $106 216%
Cigna $66 - $106 238%
Private Healthcare Systems $148 - $179 534%
Devon $158 570%
Intergroup $169 610%
Multiplan $190 685%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Way, Butler, PA 16001
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals