CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Medical Center Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $54
Cash Discount Price: $80
vs. Medicare Baseline: 1.95x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Medical Center Hospital is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.95x the Medicare baseline. Located in 500 W 4Th Street, Odessa, TX.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$54

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: $80 (289%)

Insurance Median: $54 (195%)

Cash: $80 (289% of Medicare)

Ins. Median: $54 (195% 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.

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
Corvel Wc	$16	58%
Medicaid / KanCare	$17 - $18	61%
Superior Chips	$17	61%
UnitedHealthcare	$19 - $160	69%
Aetna	$26 - $82	94%
Humana	$26	94%
Care Improvement Plus	$27	97%
Novitas Solutions	$27	97%
Triwest Va Ccn	$27	97%
Ambetter / Centene	$28	101%
Wellcare By Allwell	$28	101%
Group Resources	$32	115%
Blue Cross Blue Shield	$39 - $70	141%
Health Select	$52 - $54	188%
Workers Comp	$54	195%
90 Degree Benefits	$60 - $86	216%
State Comptroller	$62	224%
Healthsmart Preferred Care	$75 - $101	271%
Texas Mutual Wc	$82	296%
Caprock	$92 - $109	332%
Firstcare	$110	397%
Geha	$147	530%
Cigna	$218	786%

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 $80.
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 Medical Center 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.