Physical therapy (manual therapy)
Facility: Lindsborg Community Hospital
Billing Code: 97140 (CPT)
- CPT Billing Code: 97140
- Insurance Median: $105
- Cash Discount Price: $89
- vs. Medicare Baseline: 3.79x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 379% of the Medicare baseline (a markup of 279%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 | $50 | 180% |
| Tricare | $52 - $67 | 188% |
| Coventry Mcr Adv | $53 - $68 | 191% |
| Cigna | $94 - $122 | 339% |
| Coventry Comm-All Other Plans | $100 - $129 | 361% |
| UnitedHealthcare | $100 - $129 | 361% |
| Phcs Preferred-All Plans | $103 - $133 | 372% |
| Multiplan-All Plans | $103 - $133 | 372% |
| Coventry Wc | $105 - $136 | 379% |
| Health Partners -All Plans | $105 - $136 | 379% |
| Century Health-All Plans | $105 - $136 | 379% |
| Wppa-All Plans | $105 - $136 | 379% |
Consumer Guidance & Cost Commentary
For the CPT code 97140, representing physical therapy with manual therapy, the facility's cash median price is $89.00, which is lower than the negotiated rates paid by most insurance plans in this dataset. While the facility's cash price is significantly lower than the gross chargemaster of $127.00, patients with high-deductible plans may find that paying the cash rate directly is more cost-effective than relying on insurance, as the negotiated rates for in-network payers like Tricare, Coventry, and Cigna range from $50 to $136. It is important to note that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the final price compared to the direct cash price.
The facility's pricing is benchmarked against federal standards, with the Medicare amount for this service set at $27.72. The cash median of $89.00 represents a markup of approximately 3.8 times the Medicare rate, which aligns with the typical range of fair pricing found in the healthcare industry. Patients should be aware that balance billing is generally prohibited for emergency services and non-emergency care at in-network facilities under the No Surprises Act, though unexpected charges can still occur if ancillary services are out-of-network. To minimize costs, consumers are encouraged to request a prompt-pay discount or self-pay rate before scheduling, as these upfront payment options can bypass the higher administrative costs associated with insurance claims processing.