CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Texas Childrens Hospital North Austin Campus

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $182
Cash Discount Price: $190
vs. Medicare Baseline: 6.57x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Texas Childrens Hospital North Austin Campus is $182. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 6.57x the Medicare baseline. Located in 9835 North Lake Creek Parkway Bldg A, Austin, TX.

Cash / Self-Pay

$190

Average discount available for prompt cash payment at this facility.

Insurance Median

$182

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: $190 (685%)

Insurance Median: $182 (657%)

Cash: $190 (685% of Medicare)

Ins. Median: $182 (657% 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 657% of the Medicare baseline (a markup of 557%). 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
First Care Health Plan	$77 - $182	278%
UnitedHealthcare	$77 - $182	278%
Driscoll Children'S Health Plan Mcd	$85	307%
Molina Mcd	$85	307%
Blue Cross Blue Shield	$99 - $179	357%
Community Health Choice	$100 - $182	361%
Community First Health Plan Mcd	$114	411%
Cook Children'S Health Plan	$114	411%
Cigna	$162 - $182	584%
Aetna	$182	657%
Kelseycare	$185	667%
Healthsmart	$199	718%
Evolutions Healthcare	$213	768%
First Health	$250 - $270	902%
Multiplan	$256	924%
Galaxy Health Network	$270	974%

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 $190.
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 Texas Childrens Hospital North Austin Campus 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.