CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: St Francis Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $168
Cash Discount Price: $150
vs. Medicare Baseline: 6.06x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at St Francis Hospital is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 6.06x the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$168

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: $150 (541%)

Insurance Median: $168 (606%)

Cash: $150 (541% of Medicare)

Ins. Median: $168 (606% 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 606% of the Medicare baseline (a markup of 506%). 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
Blue Cross Blue Shield	$44 - $48	159%
Clear Spring Health of Illinois	$44	159%
Humana	$44	159%
Wexford	$45	162%
Molina Healthcare	$46 - $47	166%
Aetna	$46 - $147	166%
UnitedHealthcare	$46 - $209	166%
Meridian Health Plan	$49	177%
Amish Community	$59	213%
Celtic Insurance Company	$106	382%
Claim Doc	$110	397%
Hopetrust	$120	433%
Wellfirst	$134	483%
First Health	$155	559%
Caterpillar, Inc.	$168	606%
Current Health Solutions	$176	635%
Healthlink	$178	642%
Multiplan/Phcs	$178	642%
Consociate Group	$178	642%
Provider Network of America	$188	678%
Healthcare Finest Network (Hfn)	$188	678%
Live360	$209	754%
Healthscope	$209	754%
Cigna	$209	754%
Health Alliance Medical Plans	$209	754%
Illinois Breast and Cervical Cancer Program	$209	754%
Interplan	$209	754%
Naphcare	$209	754%

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 $150.
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 St Francis 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.