CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Primary Children's Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $102
  • Cash Discount Price: $105
  • vs. Medicare Baseline: 3.68x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Primary Children's Hospital is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.68x the Medicare baseline. Located in 100 North Mario Capecchi Drive, Salt Lake City, UT.
Cash / Self-Pay
$105

Average discount available for prompt cash payment at this facility.

Insurance Median
$102

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: $105 (379%)
Insurance Median: $102 (368%)
Cash: $105 (379% of Medicare)
Ins. Median: $102 (368% 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 368% of the Medicare baseline (a markup of 268%). 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
Health Plan Of Nevada $22 - $26 79%
American Health $26 - $80 94%
Healthy U $26 - $27 94%
Molina $26 - $119 94%
Selecthealth $26 - $119 94%
Southwest Behavioral Health $26 94%
Tricare $26 94%
Triwest $26 94%
UnitedHealthcare $26 - $119 94%
Donor Connect $50 - $56 180%
Aetna $99 - $120 357%
Awh Connected $99 - $120 357%
Byu Athletics $99 - $119 357%
Campbell Scientific $99 - $119 357%
Cigna $99 - $119 357%
Deseret Mutual $99 - $119 357%
Emi $99 - $119 357%
Emi Health $99 - $119 357%
First Choice $99 - $119 357%
First Choice Of The Midwest $99 - $119 357%
Franklin County $99 - $119 357%
Global Excel $99 - $119 357%
Health Utah $99 - $119 357%
Humana $99 - $119 357%
Hygeia Corporation $99 - $119 357%
Ifit $99 - $119 357%
Juniper Systems $99 - $119 357%
Lw Miller $99 - $119 357%
Managed Care Admin $99 - $119 357%
Medcare International $99 - $119 357%
Motivhealth $99 - $119 357%
Pehp $99 - $119 357%
Prodegi Corp Benefit $99 - $119 357%
Tanner Llc $99 - $119 357%
Uofu $99 - $119 357%
Utah Tech $99 - $119 357%
Wise Network $99 - $119 357%
First Health $101 - $120 364%
Blue Cross Blue Shield $102 - $121 368%
Springtide $102 - $121 368%
Utah Behavioral Health Network $113 - $114 408%
Altius Mhnet Behavioral Health $123 - $124 444%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 North Mario Capecchi Drive, Salt Lake City, UT 84113
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens