CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Watsonville Community Hospital
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $205
- Cash Discount Price: $205
- vs. Medicare Baseline: 7.40x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Watsonville Community Hospital is $205. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $205. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 7.40x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$205
Average discount available for prompt cash payment at this facility.
Insurance Median
$205
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: $205 (740%)
Insurance Median: $205 (740%)
Cash: $205 (740% of Medicare)
Ins. Median: $205 (740% 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 740% of the Medicare baseline (a markup of 640%). 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.
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 |
|---|---|---|
| Healthy Families | $28 - $33 | 101% |
| Medicaid / KanCare | $28 - $33 | 101% |
| Ccs/Monterey County | $28 - $33 | 101% |
| Medi-Cal/Eds | $28 - $33 | 101% |
| Medi-Cal E.R. | $28 - $33 | 101% |
| California Childrens Srvs | $28 - $33 | 101% |
| Well Path | $28 - $342 | 101% |
| Miscellaneous Work Comp | $29 | 105% |
| Medicare (plans) | $29 - $31 | 105% |
| Tricare | $29 | 105% |
| Travelers Insurance | $29 - $342 | 105% |
| Keenan & Assoc Work Comp | $29 | 105% |
| Fleming & Associates | $29 | 105% |
| Blue Shield PPO | $29 | 105% |
| Western Growers Work Comp | $29 | 105% |
| Hartford Workers' Comp | $29 | 105% |
| Kemper Group Workers Comp | $29 | 105% |
| U.S. Dept. of Labor | $29 | 105% |
| Republic Idemnity W/Comp | $29 | 105% |
| Pinnacle Healthcare Uc | $29 | 105% |
| Gallagher Bassett Svcs | $29 | 105% |
| Workers Comp | $29 | 105% |
| Fireman's Fund Work Comp | $29 | 105% |
| Veterans Administration | $29 | 105% |
| Ace-Usa | $29 | 105% |
| Liberty Mutual Work Comp | $29 | 105% |
| Beta Healthcare Group | $29 | 105% |
| Crawford & Co | $29 | 105% |
| Alignment Health Plan | $31 | 112% |
| Secure Horizons Dign HMO | $31 - $68 | 112% |
| Secure Horizons | $31 | 112% |
| UnitedHealthcare | $31 - $205 | 112% |
| Health Net of California | $31 - $214 | 112% |
| Alliance/Sccho | $33 - $55 | 119% |
| Medicruz | $62 | 224% |
| Victim Compensation Plan | $62 - $342 | 224% |
| Pacificare HMO | $68 - $205 | 245% |
| Cigna | $68 - $239 | 245% |
| Blue Cross Blue Shield | $68 - $304 | 245% |
| Great-West/Phcs | $68 - $239 | 245% |
| Health Net Pmg HMO | $68 - $214 | 245% |
| Blue Shield HMO | $68 | 245% |
| Aetna | $68 - $280 | 245% |
| Kaiser Northern | $95 | 343% |
| Pinnacle Claims Tpa/Bc | $137 - $304 | 494% |
| Western Growers Trust/Bc | $137 - $304 | 494% |
| Western Health Advantage | $171 | 617% |
| Health Net Smartcare Netw | $205 | 740% |
| Self Pay | $205 | 740% |
| Pacificare PPO | $205 | 740% |
| Health Net Blue and Gold | $214 | 772% |
| Health Net Canopycare HMO | $214 | 772% |
| Geha (Ccn) | $239 - $273 | 862% |
| Transwestern | $239 - $273 | 862% |
| First Health | $239 - $273 | 862% |
| Adventist Risk Management | $239 - $273 | 862% |
| Multiplan Inc PPO | $267 | 963% |
| Private Healthcare System | $267 | 963% |
| Salinas Valley Mem Hops | $290 | 1046% |
| Coastal Healthcare Admin | $290 - $308 | 1046% |
| Robert Kennedy/Ccn | $296 - $304 | 1068% |
| State Compensation Fund | $296 - $304 | 1068% |
| Monterey Bay Pub Emp Trst | $296 - $304 | 1068% |
| Delta Health Systems | $296 - $304 | 1068% |
| Laborers Health & Welfare | $296 - $304 | 1068% |
| Operating Engineers | $296 - $304 | 1068% |
| Calif Ironworkers Field | $296 - $304 | 1068% |
| Sheet Metal Workers | $296 - $304 | 1068% |
| Claims Management Wc | $296 - $304 | 1068% |
| Teamsters Benefit Trust | $296 - $304 | 1068% |
| City of Wats/Pinnacle Clm | $296 - $304 | 1068% |
| Carpenters H&W Trust | $296 - $304 | 1068% |
| Prucare Pmg HMO | $342 | 1234% |
| Wholesale Beer Distributo | $342 | 1234% |
| Humana | $342 | 1234% |
| Apwu Health Plan | $342 | 1234% |
| Miscellaneous Insurance | $342 | 1234% |
| Farmers Insurance | $342 | 1234% |
| United Administrative | $342 | 1234% |
| State Farm Ins | $342 | 1234% |
| Sutter Health Plus | $342 | 1234% |
| Bankers Life & Casualty | $342 | 1234% |
| Miscellaneous Auto | $342 | 1234% |
| Prucare Pmg POS | $342 | 1234% |
| Aarp | $342 | 1234% |
| Aaa | $342 | 1234% |
| Physicians Mutual | $342 | 1234% |
| Zenith National Ins | $342 | 1234% |
| North Calif Bakery Driver | $342 | 1234% |
| Allstate | $342 | 1234% |