CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Blount Memorial Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $84
Cash Discount Price: $43
vs. Medicare Baseline: 3.03x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Blount Memorial Hospital is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.03x the Medicare baseline. Located in 907 E Lamar Alexander Parkway, Maryville, TN.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$84

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: $43 (155%)

Insurance Median: $84 (303%)

Cash: $43 (155% of Medicare)

Ins. Median: $84 (303% 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 303% of the Medicare baseline (a markup of 203%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medicaid / KanCare	$22 - $30	79%
UnitedHealthcare	$22 - $190	79%
Blue Cross Blue Shield	$26 - $121	94%
Humana	$26	94%
Medicare (plans)	$26 - $27	94%
Tricare	$26	94%
Cigna	$27 - $186	97%
Prisma Health Seniorcare Pace - Midlands [5400]	$32	115%
Prisma Health Seniorcare Pace-Upstate [5200]	$32	115%
Ambetter / Centene	$41	148%
Promise Health Plan Contracted [2401]	$49 - $84	177%
Orangeburg Senior Helping Center Pace [5401]	$56	202%
Consociate Health Contracted [4835]	$58	209%
Bob Jones Univ-Pai [821]	$84	303%
Preferred Administrators Contracted [2839]	$98	354%
Medcost [2940]	$104 - $116	375%
Atlantic Packaging Contracted [4833]	$105	379%
Aps Healthcare System [2981]	$112	404%
Multiplan/Phcs Contracted [2950]	$125	451%
Aetna	$126	455%
Meritain Health Contracted [2200]	$126	455%
Nippon [2300]	$126	455%
Vsp Vision Care [2986]	$126	455%
First Health Contracted [2952]	$130	469%
Furman Int/Allen University Student [2951]	$130	469%
Quiktrip-First Health [3067]	$130	469%
Fairos/Occunet Contracted [4837]	$175	631%
Mvp Health Care [3037]	$186	671%
Golden Rule Insurance Company [2991]	$190	685%
Oxford Health Plans [2992]	$190	685%

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 $43.
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 Blount Memorial Hospital 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.