CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Carilion Franklin Memorial Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $113
Cash Discount Price: $59
vs. Medicare Baseline: 4.08x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Carilion Franklin Memorial Hospital is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.08x the Medicare baseline. Located in 180 Floyd Avenue, Rocky Mount, VA.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $59 (213%)

Insurance Median: $113 (408%)

Cash: $59 (213% of Medicare)

Ins. Median: $113 (408% 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 408% of the Medicare baseline (a markup of 308%). 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	$28	101%
Sentara Health Plan	$28 - $108	101%
Abh Of Va (Formerly Coventry)	$29	105%
Abh Of Wva (Formerly Coventry)	$29	105%
Humana	$29	105%
UnitedHealthcare	$29 - $143	105%
Aetna	$83 - $116	299%
Gateway - Tier 3	$90 - $96	325%
Vhn - Ultra	$102 - $108	368%
Cigna	$111 - $126	400%
Connecticare	$115 - $122	415%
Vhn - Plus	$126 - $135	455%
Gateway - Tier 2	$131 - $140	473%
Vhn	$131 - $140	473%
Vhn - Link	$148 - $158	534%
Gateway - Tier 1	$156 - $166	563%
Vhn - Secondary Payors	$156 - $166	563%

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 $59.
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 Carilion Franklin Memorial 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.