CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Mercyone Elkader Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $146
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 5.27x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Mercyone Elkader Medical Center is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 5.27x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$146

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$27.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $27.72 (100%)
Cash / Self-Pay: $129 (465%)
Insurance Median: $146 (527%)
Cash: $129 (465% of Medicare)
Ins. Median: $146 (527% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $27.72 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 527% of the Medicare baseline (a markup of 427%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $102 368%
Aetna $103 - $146 372%
Medicare (plans) $104 - $107 375%
UnitedHealthcare $109 - $173 393%
Iowa Total Care $123 444%
Medicaid / KanCare $125 - $126 451%
Amish Hospital Aid $137 494%
1199 National Benefit Fund $146 527%
Allied Benefit Systems $146 527%
Asr Health Benefits $146 527%
Christian Brother Services $146 527%
Coventry $146 527%
First Health $146 527%
Lucent Health $146 527%
Luminare Health $146 527%
Medical Mutual $146 527%
Meritain $146 527%
Trustmark Small Business Benefits $146 527%
Webtpa $146 527%
Centivo $154 556%
Health Choices $158 570%
Medical Associates $158 570%
Ambetter / Centene $173 624%
Geha $173 624%
Health Partners $190 685%
Auxiant $194 700%
Cigna $194 700%
Medica $194 700%
Midlands $194 700%
Midlands Choice $194 700%
Crime Victim Assistance $198 714%
Iowa Dept Of Public Health $198 714%
Claimdoc $207 747%
Nova $207 747%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 Davidson Street Nw, Elkader, IA 52043
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals