CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Mercy Medical Center-New Hampton

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $188
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 6.47x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mercy Medical Center-New Hampton is $188. 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 6.47x the Medicare baseline. Located in 308 North Maple Avenue, New Hampton, IA.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$188

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: $188 (647%)
Cash: $129 (444% of Medicare)
Ins. Median: $188 (647% 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 647% of the Medicare baseline (a markup of 547%). 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 $79 272%
Aetna $80 - $188 275%
Medicare (plans) $80 - $89 275%
UnitedHealthcare $84 - $138 289%
Health Choices $100 344%
Medical Associates $100 344%
Amish Hospital Aid $106 365%
Oscar $117 403%
Ambetter / Centene $134 461%
Iowa Total Care $136 468%
Geha $138 475%
Medicaid / KanCare $138 - $139 475%
Claimdoc $160 551%
Nova $160 551%
1199 National Benefit Fund $188 647%
Allied Benefit Systems $188 647%
Asr Health Benefits $188 647%
Coventry $188 647%
First Health $188 647%
Lucent Health $188 647%
Luminare Health $188 647%
Medical Mutual $188 647%
Meritain $188 647%
Trustmark Small Business Benefits $188 647%
Webtpa $188 647%
First Choice Health $189 650%
Health Partners $191 657%
Auxiant $193 664%
Cigna $193 664%
Medica $193 664%
Midlands $193 664%
Midlands Choice $193 664%
Crime Victim Assistance $199 685%
Iowa Dept Of Public Health $199 685%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 308 North Maple Avenue, New Hampton, IA 50659
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals