CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Reston Hospital Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $47
Cash Discount Price: $227
vs. Medicare Baseline: 1.70x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Reston Hospital Center is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $227. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.70x the Medicare baseline. Located in 1850 Town Center Parkway, Reston, VA.

Cash / Self-Pay

$227

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $227 (819%)

Insurance Median: $47 (170%)

Cash: $227 (819% of Medicare)

Ins. Median: $47 (170% 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
Aetna	$27 - $31	97%
Devoted	$27 - $31	97%
Humana	$27 - $31	97%
Sentara Health	$27 - $31	97%
United	$27 - $104	97%
Blue Cross Blue Shield	$28 - $32	101%
Cigna	$28 - $32	101%
Davita Village Health	$28 - $32	101%
Virginia Premier Health	$28 - $31	101%
Align Senior Care	$29 - $33	105%
Clear Spring Health Plan	$29 - $32	105%
Pyramid Life	$29 - $33	105%
Johns Hopkins	$30	108%
Lifeworks	$42 - $44	152%
Carefirst	$45	162%
Universal Healthcare Group	$49 - $51	177%
Bright Health	$55 - $58	198%
Greenvbrier Sporting Club	$132 - $139	476%
Virginia Health Network	$157 - $164	566%
Corvel	$159 - $166	574%
Occunet Workers Comp	$177 - $185	639%
4Most Health Network	$199 - $208	718%

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 $227.
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 Reston Hospital 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.