CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: North Austin Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $84
  • Cash Discount Price: $352
  • vs. Medicare Baseline: 3.03x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at North Austin Medical Center is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $352. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.03x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$352

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: $352 (1270%)
Insurance Median: $84 (303%)
Cash: $352 (1270% 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.

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 $11 - $69 40%
Wellmed $24 - $28 87%
Aetna $25 - $166 90%
Blue Cross Blue Shield $25 - $164 90%
Cigna $25 - $93 90%
Devoted Health $25 - $28 90%
Humana $25 - $28 90%
Odyssey Hospice $25 - $28 90%
St David’S Hospice $25 - $28 90%
Triwest Healthcare Alliance $25 - $28 90%
UnitedHealthcare $25 - $181 90%
American Health Plan Of Texas $26 - $30 94%
Shared Health $26 - $30 94%
United $26 - $181 94%
Molina Healthcare $27 - $31 97%
Provider Partners Health Plan $27 - $30 97%
Pyramid Life $27 - $30 97%
Texas Independent Health Plan $27 - $30 97%
Wellcare $27 - $30 97%
Imperial Insurance $28 - $31 101%
Triwest Health Alliance $28 101%
Universal Health $30 - $34 108%
Austin Fc $31 - $36 112%
Amerigroup $34 123%
Sendero $34 - $49 123%
Naphcare $39 - $44 141%
Seven Corners $39 - $44 141%
Oscar $44 - $86 159%
Corvel Corporation $50 - $56 180%
Moda $53 - $95 191%
Covenant Management Systems $65 - $116 234%
Healthcare Highways $66 - $121 238%
Imo Med - Select Network $68 - $121 245%
Nomi Health $73 - $84 263%
Moda Health $82 - $149 296%
Evry Health $84 303%
Texas Healthcare Foundation Heb $84 - $149 303%
Texas Workforce Commission $89 - $157 321%
Curative Administrators $91 328%
Harbor Health Team $91 328%
Averde Health $102 - $181 368%
Comanche County $114 - $202 411%
National Choicecare $114 - $202 411%
Healthsmart Preferred Care $125 - $322 451%
Independent Medical Systems $125 - $222 451%
Physicians Cooperative Of Texas $125 - $222 451%
Prime Health $136 - $242 491%
First Health $142 - $286 512%
Coastal Comp Health Networks $148 - $262 534%
National Health Care $148 - $262 534%
Texas Municipal League $159 - $282 574%
Medcorp Southwest $170 - $302 613%
Rockport Healthcare Group $182 - $363 657%
Bce Emergis Corporation $204 - $363 736%
Beech Street $204 - $363 736%
Medical Control Network Solutions $204 - $363 736%
Multiplan $204 - $363 736%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals