CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Rio Grande Regional Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $28
  • Cash Discount Price: $783
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Rio Grande Regional Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $783. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.01x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
$783

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $783 (2825%)
Insurance Median: $28 (101%)
Cash: $783 (2825% of Medicare)
Ins. Median: $28 (101% 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.

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
Wellmed $23 - $26 83%
Aetna $24 - $27 87%
Allegian Health $24 - $27 87%
Blue Cross Blue Shield $24 - $352 87%
Cigna $24 - $27 87%
Humana $24 - $376 87%
Independent Medical System $24 - $27 87%
Triwest Healthcare Alliance $24 - $27 87%
United $24 - $352 87%
American Health Plan $25 - $28 90%
Physicians Health Choice $25 - $28 90%
Prominence Health $25 - $28 90%
Provider Partners Health Plan Of Texas $25 - $29 90%
Shared Health $25 - $28 90%
Superior Health Plan $25 - $55 90%
Molina $26 - $29 94%
Triwest Health Alliance $26 94%
Universal Health Care $29 - $32 105%
Superior $37 - $42 133%
Corvel Corporation $47 - $54 170%
Focus Healthcare $48 - $54 173%
Omni Healthcare $50 - $57 180%
Molina Healthcare $58 - $66 209%
Texas Workforce Commission $188 678%
Oscar $213 768%
Averde Health $258 931%
Texas Athletic Network $300 - $600 1082%
Healthsmart Preferred Care $337 - $665 1216%
First Health $450 1623%
National Healthcare Solutions $470 1696%
Southwest Medical $470 1696%
Coastal Comp $509 1836%
Usa Managed Care $509 - $626 1836%
Ppo Next/ Medical Control $587 2118%
Beech Street $626 2258%
Multiplan $626 2258%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 E Ridge Rd, McAllen, TX 78503
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals