CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Mercyone Dubuque Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $56
  • Cash Discount Price: $916
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mercyone Dubuque Medical Center is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $916. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.93x the Medicare baseline. Located in 250 Mercy Drive, Dubuque, IA.
Cash / Self-Pay
$916

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: $916 (3152%)
Insurance Median: $56 (193%)
Cash: $916 (3152% 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 - $51 86%
Medicaid / KanCare $26 - $51 89%
Aetna $27 - $124 93%
Medicare (plans) $27 - $28 93%
Blue Cross Blue Shield $28 96%
UnitedHealthcare $28 - $231 96%
Amish Hospital Aid $37 127%
Oscar $38 131%
Centivo $44 151%
Ambetter / Centene $47 162%
Preferred Health Choice $53 182%
Health Choices $54 186%
Claimdoc $56 193%
Nova $56 193%
Midlands Choice $86 - $133 296%
The Alliance $89 306%
Wps $89 306%
Mhnet $118 406%
1199 National Benefit Fund $124 427%
Allied Benefit Systems $124 427%
Asr Health Benefits $124 427%
Christian Brother Services $124 427%
Coventry $124 427%
First Health $124 427%
Lucent Health $124 427%
Luminare Health $124 427%
Medical Mutual $124 427%
Meritain $124 427%
Trustmark Small Business Benefits $124 427%
Webtpa $124 427%
Auxiant $133 458%
Cigna $133 458%
Medica $133 458%
Midlands $133 458%
Multiplan $133 458%
Unity $133 458%
Crime Victim Assistance $148 509%
Iowa Dept Of Public Health $148 509%
Stephenson Cty Health $148 509%
Geha $212 - $231 730%

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