CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Texas Orthopedic Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $43
  • Cash Discount Price: $386
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Texas Orthopedic Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $386. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.55x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$386

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $386 (1392%)
Insurance Median: $43 (155%)
Cash: $386 (1392% of Medicare)
Ins. Median: $43 (155% 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
Superior Health Plan $18 - $29 65%
Oscar $24 - $81 87%
Wellmed $24 - $28 87%
Amerigroup $25 - $58 90%
Blue Cross Blue Shield $25 - $145 90%
Cigna $25 - $28 90%
Devoted Health $25 - $28 90%
Humana $25 - $269 90%
Integranet Amerigroup Ipa $25 - $29 90%
Kelsey Seybold $25 - $28 90%
Triwest Healthcare Alliance $25 - $28 90%
United $25 - $186 90%
Van Lang Ipa $25 - $28 90%
Wellcare $25 - $29 90%
American Health Plan $26 - $29 94%
Procare Advantage $26 - $29 94%
Provider Partners Health Plan Of Texas $26 - $30 94%
Shared Health $26 - $29 94%
Molina $27 - $30 97%
Christus (Usfhp) $28 101%
Universal Healthcare Group $29 - $33 105%
Verda Health Plan $32 - $36 115%
Community Health Choice $36 - $40 130%
Superior $36 - $43 130%
Community Health Choice Mcd $40 - $54 144%
Corvel Corporation $49 - $55 177%
Texas Childrens Health Plans $51 - $98 184%
Omni Healthcare $52 - $59 188%
Molina Healthcare $54 - $61 195%
Aetna $71 - $129 256%
Texas Workforce Commission $74 - $99 267%
Healthsmart Preferred Care $132 - $351 476%
Fidelis Securecare Of Tx $138 - $186 498%
Coventry National First Health $164 - $220 592%
Physicians Cooperative Of Texas $169 - $227 610%
Rockport Workers Comp $169 - $227 610%
Independent Medical System $184 - $248 664%
National Healthcare Solutions $184 - $248 664%
Southwest Medical $184 - $248 664%
Coastal Comp $200 - $269 722%
Multiplan $230 - $351 830%
International Health Insurance $246 - $331 887%
Physicians, Inc $261 - $351 942%
Affiliated Ppo $276 - $372 996%
Texas Athletic Network $300 - $600 1082%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals