CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Sheridan Memorial Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $114
Cash Discount Price: $101
vs. Medicare Baseline: 4.11x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Sheridan Memorial Hospital is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.11x the Medicare baseline. Located in 1401 W 5Th St, Sheridan, WY.

Cash / Self-Pay

$101

Average discount available for prompt cash payment at this facility.

Insurance Median

$114

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: $101 (364%)

Insurance Median: $114 (411%)

Cash: $101 (364% of Medicare)

Ins. Median: $114 (411% 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 411% of the Medicare baseline (a markup of 311%). 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
Humana	$28	101%
Blue Cross Blue Shield	$102 - $107	368%
Wy School Boards-All Plans	$103 - $108	372%
UnitedHealthcare	$105 - $111	379%
Pacificsource-All Plans	$108 - $114	390%
C1 Employee - All Plans	$111 - $116	400%
Casper Opco Llc - All Plans	$111 - $116	400%
First Health Comm - All Plans	$111 - $116	400%
Miscellaneous-All Plans	$111 - $116	400%
Cigna	$113 - $120	408%
Wise Provider Network-All Plans	$114 - $120	411%
Ebms - All Plans	$117 - $123	422%
First Choice Comm - All Plans	$117 - $123	422%
Phcs Multiplan-All Plans	$117 - $123	422%
Three Rivers-All Plans	$117 - $123	422%

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 $101.
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 Sheridan 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.