CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Pennsylvania Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $164
  • Cash Discount Price: $411
  • vs. Medicare Baseline: 5.92x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Pennsylvania Hospital is $164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $411. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 5.92x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$411

Average discount available for prompt cash payment at this facility.

Insurance Median
$164

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: $411 (1483%)
Insurance Median: $164 (592%)
Cash: $411 (1483% of Medicare)
Ins. Median: $164 (592% 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 592% of the Medicare baseline (a markup of 492%). 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
Health Partners $18 - $411 65%
Tricare $28 101%
Us Family Health Plan $28 101%
Blue Cross Blue Shield $29 - $411 105%
Cigna $29 - $139 105%
Geisinger Health Plan $29 - $91 105%
Humana $29 - $329 105%
Ibc $29 105%
Medicare (plans) $29 105%
Philadelphia Va Medical Center $29 105%
Upmc $29 - $411 105%
Aetna $30 - $411 108%
Pa Health And Wellness $30 - $47 108%
Penn Life (Living Independently For Elders) $30 108%
UnitedHealthcare $30 - $411 108%
Clover Health Plan $31 112%
Keystone First $32 115%
Gateway Health Plan $35 126%
Elap $41 148%
Claims Watcher $46 - $51 166%
Oscar Health Plan $49 177%
Centivo $51 184%
Elap Services $53 191%
Highmark $60 216%
Horizon Nj Health $69 - $72 249%
Medicaid / KanCare $74 - $411 267%
Penn Global Medicine $76 274%
Keystone Mercy Health Plan $82 296%
Pgm - Regie De L'Assurance Maladie Quebec $95 343%
Ibc Commercial Hpn $103 372%
Keystone Hmo Proactive $105 379%
Preferred Health Care Eliance $107 386%
Pgm - Kuwait Defense $144 - $185 519%
Devon $156 - $185 563%
Qualcare $156 563%
Coventry $164 - $210 592%
Pgm - Chop $164 592%
Wissahickon Hospice $164 592%
Healthamerica/Coventry $185 - $201 667%
Olympus $200 722%
First Health Global $206 743%
Urn-Cancer Resource Services $206 743%
Health Net $247 891%
Pgm - Royal Embassy Of Saudi Arabia $247 891%
Pgm - Embassy Of Qatar $267 963%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $267 963%
Pgm - Embassy Of The United Emirates/Ipc $288 1039%
Devon Health Services Inc $329 1187%
Health America/Ccn $329 1187%
Intergroup $329 1187%
Pgm - Kuwait Health Division $329 1187%
Pgm - Kuwait Oil $329 1187%
Preferred Care $329 1187%
Commercial Other $411 1483%
Community Behavioral Health $411 1483%
International Pfs $411 1483%
Quest Behavioral Health $411 1483%
United Behavioral Health $411 1483%
Workers Compensation $411 1483%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals