CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Mercyone Dyersville Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $165
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 5.04x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Mercyone Dyersville Medical Center is $165. 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 5.04x the Medicare baseline. Located in 1111 3Rd Street Sw, Dyersville, IA.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$165

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: $165 (504%)
Cash: $129 (394% of Medicare)
Ins. Median: $165 (504% 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 504% of the Medicare baseline (a markup of 404%). 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
Health Choices $75 229%
Blue Cross Blue Shield $110 336%
Medicare (plans) $113 - $123 345%
UnitedHealthcare $118 - $179 361%
The Alliance $121 370%
Iowa Total Care $138 422%
Medicaid / KanCare $140 - $141 428%
Amish Hospital Aid $148 452%
1199 National Benefit Fund $165 504%
Aetna $165 504%
Allied Benefit Systems $165 504%
Asr Health Benefits $165 504%
Christian Brother Services $165 504%
Coventry $165 504%
First Health $165 504%
Luminare Health $165 504%
Medical Mutual $165 504%
Meritain $165 504%
Trustmark Small Business Benefits $165 504%
Webtpa $165 504%
Auxiant $179 547%
Cigna $179 547%
Geha $179 547%
Medica $179 547%
Midlands $179 547%
Midlands Choice $179 547%
Multiplan $179 547%
Ambetter / Centene $187 571%
Crime Victim Assistance $199 608%
Iowa Dept Of Public Health $199 608%
Claimdoc $224 684%
Nova $224 684%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 3Rd Street Sw, Dyersville, IA 52040
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals