CMS Price Transparency Data
Physical therapy (therapeutic exercise)
Facility: Mercy Health Saint Mary's
Billing Code: 97110 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97110
- Insurance Median: $78
- Cash Discount Price: $85
- vs. Medicare Baseline: 2.68x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mercy Health Saint Mary's is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.68x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$85
Average discount available for prompt cash payment at this facility.
Insurance Median
$78
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: $85 (292%)
Insurance Median: $78 (268%)
Cash: $85 (292% of Medicare)
Ins. Median: $78 (268% 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 268% of the Medicare baseline (a markup of 168%). 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.
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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 | $15 - $76 | 52% |
| Medicaid / KanCare | $15 - $16 | 52% |
| Access Health | $20 | 69% |
| Aetna | $27 - $99 | 93% |
| Blue Care Network Advantage | $27 | 93% |
| Medicare (plans) | $27 | 93% |
| Align Senior Care | $28 | 96% |
| Correctional Recovery | $28 | 96% |
| Hospice Faith | $28 | 96% |
| Hospice Of Holland | $28 | 96% |
| UnitedHealthcare | $29 - $157 | 100% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $32 | 110% |
| Molina Marketplace | $36 | 124% |
| Oscar | $36 | 124% |
| Vitalcore | $43 | 148% |
| Wellpath | $43 | 148% |
| U Of M Health Plan | $44 - $119 | 151% |
| Bcn Domestic | $50 - $76 | 172% |
| Blue Benefit Administrators Of Massachusetts | $50 - $76 | 172% |
| Blue Care Network | $50 - $76 | 172% |
| Blue Distinction Transplant | $50 - $76 | 172% |
| Blue Shield - Ca | $50 - $76 | 172% |
| Blue Shield - Id (Regence) | $50 - $76 | 172% |
| Blue Shield - Ny Highmark Northeastern | $50 - $76 | 172% |
| Blue Shield - Ny Highmark Western | $50 - $76 | 172% |
| Blue Shield - Pa (Highmark) | $50 - $76 | 172% |
| Blue Shield - Wa (Regence) | $50 - $76 | 172% |
| Health Choices | $50 - $119 | 172% |
| Kaiser Domestic | $50 - $76 | 172% |
| Wc Accident Fund | $56 - $86 | 193% |
| Wc Advantage | $56 - $86 | 193% |
| Wc Aig | $56 - $86 | 193% |
| Wc Allied | $56 - $86 | 193% |
| Wc Amerisure | $56 - $86 | 193% |
| Wc Amtrust | $56 - $86 | 193% |
| Wc Asu Risk Mgt | $56 - $86 | 193% |
| Wc Berkley Admin | $56 - $86 | 193% |
| Wc Broadspire | $56 - $86 | 193% |
| Wc Bunch & Associates | $56 - $86 | 193% |
| Wc Ccmsi | $56 - $86 | 193% |
| Wc Emc Insurance Company | $56 - $86 | 193% |
| Wc Esis | $56 - $86 | 193% |
| Wc Fcci | $56 - $86 | 193% |
| Wc Federated | $56 - $86 | 193% |
| Wc Gallagher Bassett | $56 - $86 | 193% |
| Wc Genex Care For Ohio | $56 - $86 | 193% |
| Wc Guard Insurance Company | $56 - $86 | 193% |
| Wc Hartford | $56 - $86 | 193% |
| Wc Liberty Mutual | $56 - $86 | 193% |
| Wc Meijers | $56 - $86 | 193% |
| Wc Michigan | $56 - $86 | 193% |
| Wc Mitchell Frankenmuth | $56 - $86 | 193% |
| Wc Pma | $56 - $86 | 193% |
| Wc Sedgwick | $56 - $86 | 193% |
| Wc Sentry | $56 - $86 | 193% |
| Wc Travelers | $56 - $86 | 193% |
| Wc Tristar | $56 - $86 | 193% |
| Wc Walmart | $56 - $86 | 193% |
| Wc Zurich | $56 - $86 | 193% |
| Nomi Health | $58 - $88 | 200% |
| Acs Benefit Services | $59 - $90 | 203% |
| Allied Benefit Systems | $59 - $90 | 203% |
| Claimchoice Adminstrators | $59 - $90 | 203% |
| Consociate | $59 - $90 | 203% |
| Cypress Benefit Administrators | $59 - $90 | 203% |
| Forest County Potawatomi | $59 - $90 | 203% |
| Health Smart | $59 - $90 | 203% |
| Healthgram | $59 - $90 | 203% |
| Healthscope | $59 - $90 | 203% |
| Secureone Preferred United Plans | $59 - $90 | 203% |
| Sisco Benefits | $59 - $90 | 203% |
| The Health Plan | $59 - $90 | 203% |
| Trustmark Small Business Benefits | $59 - $90 | 203% |
| Unified Group Services | $59 - $90 | 203% |
| Webtpa | $59 - $90 | 203% |
| Geha | $65 - $119 | 224% |
| Medical Mutual | $65 - $99 | 224% |
| Meritain | $65 - $99 | 224% |
| Preferred One | $65 - $99 | 224% |
| Asr Health Benefits | $66 - $100 | 227% |
| Hap | $66 - $122 | 227% |
| Caresource | $67 - $103 | 231% |
| Varipro | $67 - $102 | 231% |
| Priority Health | $70 - $71 | 241% |
| 1199 National Benefit Fund | $75 - $115 | 258% |
| Allied National Global Care | $75 - $115 | 258% |
| Asrm - Reliance Standard Life Insurance | $75 - $115 | 258% |
| Christian Care Ministry | $75 - $115 | 258% |
| Cigna | $75 - $115 | 258% |
| Dean Health | $75 - $115 | 258% |
| Fallon Health | $75 - $115 | 258% |
| Family Life Insurance Company | $75 - $115 | 258% |
| Ghc Scw | $75 - $115 | 258% |
| Group Pension Administrators | $75 - $115 | 258% |
| International Benefit Administrators | $75 - $115 | 258% |
| Lifetime Benefit Solutions | $75 - $115 | 258% |
| Manhattan Life | $75 - $115 | 258% |
| Medi Share | $75 - $115 | 258% |
| Multiplan | $75 - $115 | 258% |
| Mvp | $75 - $115 | 258% |
| Pai | $75 - $115 | 258% |
| Pan-American Life | $75 - $115 | 258% |
| Paramount Hmo | $75 - $115 | 258% |
| Phcs | $75 - $115 | 258% |
| Trinity Health Share | $75 - $115 | 258% |
| Acclaim | $78 - $119 | 268% |
| Administrative Concepts | $78 - $119 | 268% |
| Allegeant | $78 - $119 | 268% |
| Ameriben | $78 - $119 | 268% |
| American Family | $78 - $119 | 268% |
| American Healthcare Alliance | $78 - $119 | 268% |
| American Republic | $78 - $119 | 268% |
| Amerihealth | $78 - $119 | 268% |
| Aultcare | $78 - $119 | 268% |
| Automated Benefit Services | $78 - $119 | 268% |
| Auxiant | $78 - $119 | 268% |
| Benefit Administrative Systems,Llc | $78 - $119 | 268% |
| Boon Chapman | $78 - $119 | 268% |
| Cam Administrative Services | $78 - $119 | 268% |
| Christian Brother Services | $78 - $119 | 268% |
| Christian Brothers Holy Cross | $78 - $119 | 268% |
| Comprehensive Benefits | $78 - $119 | 268% |
| Continental Life Insurance | $78 - $119 | 268% |
| Custom Benefit Administrators | $78 - $119 | 268% |
| Employee Benefit Concepts | $78 - $119 | 268% |
| Employee Benefit Management | $78 - $119 | 268% |
| Enterprise Group Planning | $78 - $119 | 268% |
| Freedom Life Insurance Company | $78 - $119 | 268% |
| Group Administrators | $78 - $119 | 268% |
| Group Marketing Services | $78 - $119 | 268% |
| Guardian | $78 - $119 | 268% |
| Health America | $78 - $119 | 268% |
| Healthez | $78 - $119 | 268% |
| Humana | $78 - $157 | 268% |
| Insight | $78 - $119 | 268% |
| Intercare | $78 - $119 | 268% |
| Jfp Benefit Management | $78 - $119 | 268% |
| Jp Farley Corporation | $78 - $119 | 268% |
| Key Benefit Administrator | $78 - $119 | 268% |
| Liberty Union Life Assurance Co | $78 - $119 | 268% |
| Lucent Health | $78 - $119 | 268% |
| Luminare Health | $78 - $119 | 268% |
| Luminare Health (Detroit) | $78 - $119 | 268% |
| Medben | $78 - $119 | 268% |
| Medcost | $78 - $119 | 268% |
| Mutual Health Services | $78 - $119 | 268% |
| Mutual Of Omaha | $78 - $119 | 268% |
| Ncas | $78 - $119 | 268% |
| Nippon Life Ins | $78 - $119 | 268% |
| Nova | $78 - $119 | 268% |
| Painters Union Insurance Fund | $78 - $119 | 268% |
| Physicians Mutual | $78 - $119 | 268% |
| Plumbers Local 98 Insurance Fund | $78 - $119 | 268% |
| Prairie States | $78 - $119 | 268% |
| Primary Physician Care | $78 - $119 | 268% |
| Professional Benefit Administrators | $78 - $119 | 268% |
| The Loomis Company | $78 - $119 | 268% |
| Unicare | $78 - $119 | 268% |
| Us Health And Life | $78 - $119 | 268% |
| Valenz | $78 - $119 | 268% |
| Western & Southern Financial Group | $78 - $119 | 268% |
| Wps | $78 - $119 | 268% |
| Coventry | $82 - $124 | 282% |
| First Health | $82 - $124 | 282% |
| Cmh Allegan County | $103 - $157 | 354% |
| Cmh Ausable Valley | $103 - $157 | 354% |
| Cmh Barry County | $103 - $157 | 354% |
| Cmh Berrien County | $103 - $157 | 354% |
| Cmh Cass County | $103 - $157 | 354% |
| Cmh Clinton-Eaton-Ingham County | $103 - $157 | 354% |
| Cmh Kalamazoo | $103 - $157 | 354% |
| Cmh Kent County | $103 - $157 | 354% |
| Cmh Lenawee County | $103 - $157 | 354% |
| Cmh Misc | $103 - $157 | 354% |
| Cmh Monroe County | $103 - $157 | 354% |
| Cmh Montcalm County | $103 - $157 | 354% |
| Cmh Muskegon County | $103 - $157 | 354% |
| Cmh Newaygo County | $103 - $157 | 354% |
| Cmh North Country | $103 - $157 | 354% |
| Cmh Northern Lakes County | $103 - $157 | 354% |
| Cmh Ottawa County | $103 - $157 | 354% |
| Cmh Van Buren County | $103 - $157 | 354% |
| Cmh West Mi County | $103 - $157 | 354% |
| Magellan Behavioral Health | $103 - $157 | 354% |