CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Mercyone Newton Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $56
  • Cash Discount Price: $2,571
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mercyone Newton Medical Center is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,571. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.93x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$2,571

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)
Cash / Self-Pay: $2,571 (8847%)
Insurance Median: $56 (193%)
Cash: $2,571 (8847% of Medicare)
Ins. Median: $56 (193% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $29.06 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 $25 86%
Medicaid / KanCare $26 - $51 89%
Aetna $27 - $186 93%
Medicare (plans) $27 - $28 93%
Blue Cross Blue Shield $28 96%
UnitedHealthcare $28 - $144 96%
Amish Hospital Aid $37 127%
Centivo $40 138%
Oscar $43 148%
Ambetter / Centene $47 162%
Claimdoc $56 193%
Nova $56 193%
Newton Correctional Facility $129 444%
Geha $144 496%
Health Choices $150 516%
Medical Associates $150 516%
Health Partners $176 606%
Auxiant $183 630%
Cigna $183 630%
Health Alliance $183 630%
Medica $183 630%
Midlands $183 630%
Midlands Choice $183 630%
1199 National Benefit Fund $186 640%
Allied Benefit Systems $186 640%
Asr Health Benefits $186 640%
Christian Brother Services $186 640%
Coventry $186 640%
First Health $186 640%
Lucent Health $186 640%
Luminare Health $186 640%
Medical Mutual $186 640%
Meritain $186 640%
Trustmark Small Business Benefits $186 640%
Webtpa $186 640%
Crime Victim Assistance $199 685%
Iowa Dept Of Public Health $199 685%

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