CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Mercyone Oelwein Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $183
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 5.59x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Mercyone Oelwein Medical Center is $183. 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 $32.73, this hospital’s rate is 5.59x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$183

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: $129 (394%)
Insurance Median: $183 (559%)
Cash: $129 (394% of Medicare)
Ins. Median: $183 (559% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 559% of the Medicare baseline (a markup of 459%). 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
Medicare (plans) $76 - $85 232%
Iowa Total Care $77 235%
Medicaid / KanCare $78 - $79 238%
Blue Cross Blue Shield $81 247%
UnitedHealthcare $86 - $172 263%
Aetna $94 - $183 287%
Amish Hospital Aid $109 333%
Centivo $122 373%
Ambetter / Centene $137 419%
Health Choices $146 446%
Medical Associates $146 446%
Claimdoc $164 501%
Nova $164 501%
Geha $172 526%
1199 National Benefit Fund $183 559%
Allied Benefit Systems $183 559%
Asr Health Benefits $183 559%
Christian Brother Services $183 559%
Coventry $183 559%
First Health $183 559%
Lucent Health $183 559%
Luminare Health $183 559%
Medical Mutual $183 559%
Meritain $183 559%
Trustmark Small Business Benefits $183 559%
Webtpa $183 559%
Health Partners $191 584%
Multiplan $193 590%
Auxiant $195 596%
Cigna $195 596%
Medica $195 596%
Midlands $195 596%
Midlands Choice $195 596%
Crime Victim Assistance $199 608%
Iowa Dept Of Public Health $199 608%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Eighth Avenue Se, Oelwein, IA 50662
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals