CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Mercy Hospital Joplin

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $98
Cash Discount Price: $122
vs. Medicare Baseline: 3.54x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Mercy Hospital Joplin is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.54x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.

Cash / Self-Pay

$122

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$27.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $27.72 (100%)

Cash / Self-Pay: $122 (440%)

Insurance Median: $98 (354%)

Cash: $122 (440% of Medicare)

Ins. Median: $98 (354% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $27.72 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 354% of the Medicare baseline (a markup of 254%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$22 - $197	79%
Medicaid / KanCare	$22 - $55	79%
Aetna	$24 - $42	87%
Humana	$24 - $58	87%
Centivo Contracted [320505]	$25	90%
Champva [20065]	$25	90%
Cherokee Nation Health Serv Contracted [320066]	$25	90%
Cigna	$25 - $150	90%
Cross Timbers Hospice [20098]	$25	90%
Dept Of Veteran Affairs Contracted [320106]	$25	90%
Elara Caring Aspire Hospice [20433]	$25	90%
Globalhealth Contracted [320145]	$25	90%
Halo Hcr Inc Hospice Contracted [320432]	$25	90%
Halo Hcr Inc Hospice [20432]	$25	90%
Indian Health Service Contracted [320198]	$25 - $127	90%
Kindful Hospice Contracted [320434]	$25	90%
Kindful Hospice [20434]	$25	90%
Medicare (plans)	$25 - $27	90%
Mercy Hospice Okc [20252]	$25	90%
Mercy Mgd Behavioral Health Contracted [320259]	$25	90%
Pace Of The Ozarks Contracted [320518]	$25	90%
Provider Partners Health Plans Contracted [320450]	$25	90%
Qual Choice Contracted [320325]	$25	90%
Tricare	$25	90%
UnitedHealthcare	$25 - $80	90%
Healthscope Contracted [320182]	$31	112%
Health Choice Contracted [320166]	$39	141%
Workers Comp [20426]	$40 - $166	144%
Ambetter / Centene	$42 - $55	152%
Home State Health Plan Contracted [320187]	$42 - $55	152%
Novasys Contracted [320285]	$42 - $55	152%
Providrs Care Network Contracted [320484]	$49	177%
Point C Contracted [320238]	$52 - $156	188%
Medica Contracted [320239]	$55 - $71	198%
United Medical Resources Contracted [320454]	$62 - $80	224%
Benefit Management Contracted [320052]	$64 - $84	231%
Health Systems Inc Contracted [320174]	$64 - $84	231%
Insurance System Inc Contracted [320465]	$64 - $84	231%
Administrative Payor Contracted [320005]	$68 - $88	245%
Mercy Benefit Admin Contracted [320251]	$75 - $195	271%
Aither Health Contracted [320449]	$86 - $111	310%
Auxiant Contracted [320462]	$86 - $127	310%
Ebms Contracted [320493]	$86 - $111	310%
Edison Health Solutions Contracted [320502]	$86 - $111	310%
Healthlink Contracted [320179]	$86 - $156	310%
Imagine 360 Contracted [320494]	$86 - $111	310%
Reflect Health Contracted [320492]	$86 - $111	310%
Yuzu Health Contracted [320521]	$86 - $111	310%
90 Degree Benefits Contracted [320436]	$90 - $195	325%
Show-Me Health Administrators Contracted [320483]	$90 - $195	325%
Preferred Health Plan Contracted [320522]	$98 - $127	354%
First Health Contracted [320128]	$102 - $133	368%
American Healthcare Alliance Contracted [320020]	$105 - $136	379%
Multiplan Contracted [320270]	$116 - $150	418%
Private Health Care Systems Contracted [320320]	$116 - $150	418%
Usable Contracted [320409]	$116 - $150	418%
Point C [20238]	$120 - $156	433%
Usa Managed Care Org Contracted [320429]	$132 - $172	476%
Ppo Plus Contracted [320310]	$135 - $176	487%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $122.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97140.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Joplin is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97140.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.