CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Mercyone Newton Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $63
  • Cash Discount Price: $2,786
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Mercyone Newton Medical Center is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,786. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.92x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$2,786

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$32.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.73 (100%)
Cash / Self-Pay: $2,786 (8512%)
Insurance Median: $63 (192%)
Cash: $2,786 (8512% of Medicare)
Ins. Median: $63 (192% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $32.73 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.

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 $26 79%
Medicaid / KanCare $27 82%
Aetna $31 - $186 95%
Blue Cross Blue Shield $31 95%
Medicare (plans) $31 - $32 95%
UnitedHealthcare $31 - $144 95%
Amish Hospital Aid $42 128%
Centivo $45 137%
Oscar $48 147%
Ambetter / Centene $53 162%
Claimdoc $63 192%
Nova $63 192%
Newton Correctional Facility $129 394%
Geha $144 440%
Health Choices $150 458%
Medical Associates $150 458%
Health Partners $176 538%
Auxiant $183 559%
Cigna $183 559%
Health Alliance $183 559%
Medica $183 559%
Midlands $183 559%
Midlands Choice $183 559%
1199 National Benefit Fund $186 568%
Allied Benefit Systems $186 568%
Asr Health Benefits $186 568%
Christian Brother Services $186 568%
Coventry $186 568%
First Health $186 568%
Lucent Health $186 568%
Luminare Health $186 568%
Medical Mutual $186 568%
Meritain $186 568%
Trustmark Small Business Benefits $186 568%
Webtpa $186 568%
Crime Victim Assistance $199 608%
Iowa Dept Of Public Health $199 608%

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