CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Mercyone Dubuque Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $63
  • Cash Discount Price: $1,213
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Mercyone Dubuque Medical Center is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,213. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.92x the Medicare baseline. Located in 250 Mercy Drive, Dubuque, IA.
Cash / Self-Pay
$1,213

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: $1,213 (3706%)
Insurance Median: $63 (192%)
Cash: $1,213 (3706% 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 - $53 79%
Medicaid / KanCare $27 - $54 82%
Aetna $31 - $108 95%
Blue Cross Blue Shield $31 95%
Medicare (plans) $31 - $32 95%
UnitedHealthcare $31 - $231 95%
Amish Hospital Aid $42 128%
Oscar $43 131%
Preferred Health Choice $46 141%
Health Choices $47 144%
Centivo $49 150%
Ambetter / Centene $53 162%
Claimdoc $63 192%
Nova $63 192%
Midlands Choice $75 - $116 229%
Wps $77 235%
The Alliance $78 238%
Mhnet $103 315%
1199 National Benefit Fund $108 330%
Allied Benefit Systems $108 330%
Asr Health Benefits $108 330%
Christian Brother Services $108 330%
Coventry $108 330%
First Health $108 330%
Lucent Health $108 330%
Luminare Health $108 330%
Medical Mutual $108 330%
Meritain $108 330%
Trustmark Small Business Benefits $108 330%
Webtpa $108 330%
Auxiant $116 354%
Cigna $116 354%
Medica $116 354%
Midlands $116 354%
Multiplan $116 354%
Unity $116 354%
Crime Victim Assistance $129 394%
Iowa Dept Of Public Health $129 394%
Stephenson Cty Health $129 394%
Geha $212 - $231 648%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Mercy Drive, Dubuque, IA 52001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals