CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Mercyone Elkader Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $146
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 5.02x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) 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 $29.06, this hospital’s rate is 5.02x 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
$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)
Cash / Self-Pay: $129 (444%)
Insurance Median: $146 (502%)
Cash: $129 (444% of Medicare)
Ins. Median: $146 (502% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 502% of the Medicare baseline (a markup of 402%). 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 $102 351%
Aetna $103 - $146 354%
Medicare (plans) $105 - $108 361%
UnitedHealthcare $110 - $174 379%
Iowa Total Care $124 427%
Medicaid / KanCare $126 434%
Amish Hospital Aid $138 475%
1199 National Benefit Fund $146 502%
Allied Benefit Systems $146 502%
Asr Health Benefits $146 502%
Christian Brother Services $146 502%
Coventry $146 502%
First Health $146 502%
Lucent Health $146 502%
Luminare Health $146 502%
Medical Mutual $146 502%
Meritain $146 502%
Trustmark Small Business Benefits $146 502%
Webtpa $146 502%
Centivo $155 533%
Health Choices $159 547%
Medical Associates $159 547%
Ambetter / Centene $174 599%
Geha $174 599%
Health Partners $191 657%
Auxiant $195 671%
Cigna $195 671%
Medica $195 671%
Midlands $195 671%
Midlands Choice $195 671%
Crime Victim Assistance $199 685%
Iowa Dept Of Public Health $199 685%
Claimdoc $208 716%
Nova $208 716%

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