CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: John Randolph Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $29
Cash Discount Price: $368
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at John Randolph Medical Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $368. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.05x the Medicare baseline. Located in 411 West Randolph Road, Hopewell, VA.

Cash / Self-Pay

$368

Average discount available for prompt cash payment at this facility.

Insurance Median

$29

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: $368 (1328%)

Insurance Median: $29 (105%)

Cash: $368 (1328% of Medicare)

Ins. Median: $29 (105% 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.

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
Triatlantic	$23	83%
Aetna	$25 - $28	90%
Devoted	$25 - $28	90%
Humana	$25 - $28	90%
Sentara Health	$25 - $28	90%
United	$25 - $166	90%
United Behavioral Health	$25 - $28	90%
Virginia Premier Health	$25 - $29	90%
Blue Cross Blue Shield	$26 - $29	94%
Cigna	$26 - $29	94%
Clear Spring Health Plan	$26 - $30	94%
Davita Village Health	$26 - $29	94%
Evernorth Behavioral Health	$26 - $29	94%
Health Net	$26	94%
Align Senior Care	$27 - $30	97%
Johns Hopkins	$27	97%
Pyramid Life	$27 - $30	97%
Naphcare	$33 - $38	119%
Oscar	$62 - $63	224%
Lifeworks	$70	253%
Universal Healthcare Group	$81	292%
Virginia Health Network	$128 - $239	462%
Value Options	$220 - $221	794%
Corvel	$264 - $265	952%
Occunet Workers Comp	$294	1061%
4Most Health Nework	$330 - $331	1190%
Multiplan	$330 - $331	1190%

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 $368.
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 John Randolph Medical Center 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.