CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Mercy Hospital Joplin

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $101
Cash Discount Price: $131
vs. Medicare Baseline: 3.09x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Mercy Hospital Joplin is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 3.09x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $131 (400%)

Insurance Median: $101 (309%)

Cash: $131 (400% of Medicare)

Ins. Median: $101 (309% 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 309% of the Medicare baseline (a markup of 209%). 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	$27 - $197	82%
Medicaid / KanCare	$27 - $57	82%
Humana	$28 - $61	86%
Aetna	$29 - $52	89%
Centivo Contracted [320505]	$29	89%
Champva [20065]	$29	89%
Cherokee Nation Health Serv Contracted [320066]	$29	89%
Cigna	$29 - $156	89%
Cross Timbers Hospice [20098]	$29	89%
Dept Of Veteran Affairs Contracted [320106]	$29	89%
Elara Caring Aspire Hospice [20433]	$29	89%
Globalhealth Contracted [320145]	$29	89%
Halo Hcr Inc Hospice Contracted [320432]	$29	89%
Halo Hcr Inc Hospice [20432]	$29	89%
Indian Health Service Contracted [320198]	$29 - $131	89%
Kindful Hospice Contracted [320434]	$29	89%
Kindful Hospice [20434]	$29	89%
Medicare (plans)	$29 - $32	89%
Mercy Hospice Okc [20252]	$29	89%
Mercy Mgd Behavioral Health Contracted [320259]	$29	89%
Pace Of The Ozarks Contracted [320518]	$29	89%
Provider Partners Health Plans Contracted [320450]	$29	89%
Qual Choice Contracted [320325]	$29	89%
Tricare	$29	89%
UnitedHealthcare	$29 - $83	89%
Healthscope Contracted [320182]	$37	113%
Workers Comp [20426]	$40 - $172	122%
Health Choice Contracted [320166]	$46	141%
Ambetter / Centene	$57	174%
Home State Health Plan Contracted [320187]	$57	174%
Novasys Contracted [320285]	$57	174%
Providrs Care Network Contracted [320484]	$58	177%
Point C Contracted [320238]	$71 - $162	217%
Medica Contracted [320239]	$74	226%
United Medical Resources Contracted [320454]	$74 - $83	226%
Benefit Management Contracted [320052]	$87	266%
Health Systems Inc Contracted [320174]	$87	266%
Insurance System Inc Contracted [320465]	$87	266%
Administrative Payor Contracted [320005]	$91	278%
Mercy Benefit Admin Contracted [320251]	$101 - $195	309%
Aither Health Contracted [320449]	$115	351%
Auxiant Contracted [320462]	$115 - $131	351%
Ebms Contracted [320493]	$115	351%
Edison Health Solutions Contracted [320502]	$115	351%
Healthlink Contracted [320179]	$115 - $162	351%
Imagine 360 Contracted [320494]	$115	351%
Reflect Health Contracted [320492]	$115	351%
Yuzu Health Contracted [320521]	$115	351%
90 Degree Benefits Contracted [320436]	$121 - $195	370%
Show-Me Health Administrators Contracted [320483]	$121 - $195	370%
Preferred Health Plan Contracted [320522]	$131	400%
First Health Contracted [320128]	$138	422%
American Healthcare Alliance Contracted [320020]	$141	431%
Multiplan Contracted [320270]	$156	477%
Private Health Care Systems Contracted [320320]	$156	477%
Usable Contracted [320409]	$156	477%
Point C [20238]	$162	495%
Usa Managed Care Org Contracted [320429]	$178	544%
Ppo Plus Contracted [320310]	$182	556%

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 $131.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97112.

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 97112.
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.