CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Mercyone Newton Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $175
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 6.31x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Mercyone Newton Medical Center is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 6.31x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$175

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: $129 (465%)
Insurance Median: $175 (631%)
Cash: $129 (465% of Medicare)
Ins. Median: $175 (631% 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 631% of the Medicare baseline (a markup of 531%). 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
Iowa Total Care $24 87%
Medicaid / KanCare $24 87%
Aetna $26 - $186 94%
Blue Cross Blue Shield $26 94%
Medicare (plans) $26 - $27 94%
UnitedHealthcare $27 - $143 97%
Amish Hospital Aid $35 126%
Centivo $38 137%
Oscar $41 148%
Ambetter / Centene $45 162%
Claimdoc $53 191%
Nova $53 191%
Newton Correctional Facility $129 465%
Geha $143 516%
Health Choices $149 538%
Medical Associates $149 538%
Health Partners $175 631%
Auxiant $182 657%
Cigna $182 657%
Health Alliance $182 657%
Medica $182 657%
Midlands $182 657%
Midlands Choice $182 657%
1199 National Benefit Fund $186 671%
Allied Benefit Systems $186 671%
Asr Health Benefits $186 671%
Christian Brother Services $186 671%
Coventry $186 671%
First Health $186 671%
Lucent Health $186 671%
Luminare Health $186 671%
Medical Mutual $186 671%
Meritain $186 671%
Trustmark Small Business Benefits $186 671%
Webtpa $186 671%
Crime Victim Assistance $198 714%
Iowa Dept Of Public Health $198 714%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 204 N 4Th Ave E, Newton, IA 50208
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals