CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Columbus Community Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $61
Cash Discount Price: $113
vs. Medicare Baseline: 2.20x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Columbus Community Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.20x the Medicare baseline. Located in 1515 Park Ave, Columbus, WI.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $113 (408%)

Insurance Median: $61 (220%)

Cash: $113 (408% of Medicare)

Ins. Median: $61 (220% 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 220% of the Medicare baseline (a markup of 120%). 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
UnitedHealthcare	$26 - $171	94%
Alliance	$34 - $150	123%
Dean Health Plan	$36 - $179	130%
My Choice Wisconsin	$36 - $61	130%
Quartz	$36 - $135	130%
Security Health Plan	$36 - $154	130%
Icare	$60 - $61	216%
Blue Cross Blue Shield	$61 - $159	220%
Cigna	$123	444%
Health Payment Systems	$154	556%
Trilogy	$169	610%
Wps	$173	624%
Healtheos	$179 - $192	646%
First Health	$181	653%
Humana	$185	667%

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 $113.
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 Columbus Community 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.