CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Sweeny Community Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $92
Cash Discount Price: $78
vs. Medicare Baseline: 3.32x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Sweeny Community Hospital is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.32x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $78 (281%)

Insurance Median: $92 (332%)

Cash: $78 (281% of Medicare)

Ins. Median: $92 (332% 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 332% of the Medicare baseline (a markup of 232%). 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
Blue Cross Blue Shield	$39 - $65	141%
Evercare Mcaid	$65	234%
UnitedHealthcare	$71 - $220	256%
Aetna	$76 - $105	274%
Amerigroup Mcr Adv - All Other Plans	$76	274%
Community Hlth Choice Him - All Other Plans	$76	274%
Coventry Mcr Adv	$76	274%
Molina Mcr Adv - All Other Plans	$76	274%
Superior Hp Mcr Adv-All Other Plans	$76	274%
Wellcare Mcare - All Plans	$76	274%
Care Improvement Mcr - All Plans	$77	278%
Choicecare Mcr Adv - All Plans	$77	278%
Community Hlth Choice Star	$92	332%
Molina Mcaid	$92	332%
Superior Hp Mcaid	$92	332%
Tx Chlidrens Hp Mcaid - All Plans	$92	332%
Tx True Choice Mcaid - All Plans	$92	332%
Beech Street - All Plans	$98	354%
Community Care Network - All Plans	$105	379%
Galaxy Health Network - All Plans	$118	426%
Multiplan - All Plans	$118	426%
Cigna	$120	433%
Evercare Mcr Adv - All Other Plans	$127	458%
Amerigroup Mcaid	$131	473%

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 $78.
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 Sweeny Community 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.