CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Charleston Area Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $65
Cash Discount Price: $302
vs. Medicare Baseline: 2.34x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Charleston Area Medical Center is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $302. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.34x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$302

Average discount available for prompt cash payment at this facility.

Insurance Median

$65

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: $302 (1089%)

Insurance Median: $65 (234%)

Cash: $302 (1089% of Medicare)

Ins. Median: $65 (234% 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 234% of the Medicare baseline (a markup of 134%). 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
Aetna	$21 - $296	76%
The Health Plan Of West Virginia Inc.	$21 - $293	76%
Unicare Health Plan Of West Virginia Inc.	$21	76%
Optimum Choice Inc.	$22	79%
Triwest Va	$25	90%
Blue Cross Blue Shield	$26 - $275	94%
Choicecare Network	$26 - $296	94%
UnitedHealthcare	$27 - $296	97%
West Virginia Senior Advantage Inc.	$27	97%
Integrated Medical Solutions	$51	184%
Naphcare	$52	188%
Caresource	$65	234%
Tricare	$181	653%
City Of Charleston	$226	815%
Cigna	$281	1014%
Three Rivers Providers Network	$293	1057%
Healthsmart	$296	1068%
Multiplan	$296	1068%

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 $302.
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 Charleston Area 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.