CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Mercyone North Iowa Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $56
  • Cash Discount Price: $1,216
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mercyone North Iowa Medical Center is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,216. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.93x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$1,216

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: $1,216 (4184%)
Insurance Median: $56 (193%)
Cash: $1,216 (4184% 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 - $76 86%
Medicaid / KanCare $26 - $77 89%
Aetna $27 - $64 93%
Medicare (plans) $27 - $28 93%
Blue Cross Blue Shield $28 96%
UnitedHealthcare $28 - $350 96%
Health Choices $31 107%
Medical Associates $31 107%
Centivo $34 117%
Amish Hospital Aid $37 127%
Oscar $37 127%
Ambetter / Centene $47 162%
Claimdoc $56 193%
Nova $56 193%
1199 National Benefit Fund $64 220%
Allied Benefit Systems $64 220%
Asr Health Benefits $64 220%
Christian Brother Services $64 220%
Coventry $64 220%
First Health $64 220%
Lucent Health $64 220%
Luminare Health $64 220%
Medical Mutual $64 220%
Meritain $64 220%
Trustmark Small Business Benefits $64 220%
Webtpa $64 220%
Preferred One $79 272%
Health Partners $81 279%
Auxiant $85 292%
Cigna $85 292%
Medica $85 292%
Midlands $85 292%
Midlands Choice $85 292%
Mhnet $97 334%
Multiplan $109 375%
Crime Victim Assistance $121 416%
Iowa Dept Of Public Health $121 416%
Geha $350 1204%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Fourth Street Sw, Mason City, IA 50401
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals