CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Holy Family Memorial

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $112
Cash Discount Price: $86
vs. Medicare Baseline: 4.04x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Holy Family Memorial is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.04x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $86 (310%)

Insurance Median: $112 (404%)

Cash: $86 (310% of Medicare)

Ins. Median: $112 (404% 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 404% of the Medicare baseline (a markup of 304%). 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	$26 - $248	94%
Community Care Incorporated	$26	94%
Health Partners	$26 - $101	94%
Humana	$26	94%
Icare	$26	94%
Molina	$26 - $29	94%
Network Health Plan	$26 - $263	94%
Security Health Plan	$26 - $125	94%
UnitedHealthcare	$26 - $370	94%
Allwell	$27	97%
Medical College Of Wisconsin	$51	184%
Centivo	$62 - $72	224%
Dean Health Plan	$78	281%
Health Payment Systems	$88	317%
Sheboygan Employers Health Network	$94	339%
Chorus Community Health Plan	$100	361%
Trilogy	$103	372%
Cigna	$112	404%
Wps Health Plan	$115	415%
Aspirus	$125	451%
Healtheos	$125	451%
Multiplan/Private Healthcare Systems	$125	451%
Preferred One	$125	451%
Healthsmart	$129	465%
First Health Network	$137	494%

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 $86.
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 Holy Family Memorial 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.