CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Mercy Hospital St Louis

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $70
  • Cash Discount Price: $88
  • vs. Medicare Baseline: 2.53x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Mercy Hospital St Louis is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $88. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.53x the Medicare baseline. Located in 615 New Ballas Road, Saint Louis, MO.
Cash / Self-Pay
$88

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $88 (317%)
Insurance Median: $70 (253%)
Cash: $88 (317% of Medicare)
Ins. Median: $70 (253% 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 253% of the Medicare baseline (a markup of 153%). 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
Aetna $7 - $184 25%
Medicaid / KanCare $7 - $145 25%
American Health Advantage Of Mo Mcr [10473] $26 94%
Blue Cross Blue Shield $26 - $274 94%
Cherokee Nation Health Serv Contracted [320066] $26 94%
Cross Timbers Hospice [20098] $26 94%
Dept Of Veteran Affairs Contracted [320106] $26 94%
Elara Caring Aspire Hospice Contracted [320433] $26 94%
Elara Caring Aspire Hospice [20433] $26 94%
Globalhealth Contracted [320145] $26 94%
Halo Hcr Inc Hospice Contracted [320432] $26 94%
Halo Hcr Inc Hospice [20432] $26 94%
Humana $26 94%
Kindful Hospice Contracted [320434] $26 94%
Kindful Hospice [20434] $26 94%
Medicare (plans) $26 - $162 94%
Mercy Hospice Okc [20252] $26 94%
Pace Of The Ozarks Contracted [320518] $26 94%
Qual Choice Contracted [320325] $26 94%
Tricare $26 94%
UnitedHealthcare $26 - $193 94%
Cigna $27 - $233 97%
Medica Contracted [320239] $28 - $137 101%
Ambetter / Centene $29 - $145 105%
Home State Health Plan Contracted [320187] $29 - $145 105%
Novasys Contracted [320285] $29 - $145 105%
Provider Partners Health Plans Contracted [320450] $29 105%
Healthscope Contracted [320182] $33 119%
Centivo Contracted [320505] $44 159%
Aither Health Contracted [320449] $46 - $215 166%
Aither Health [20449] $46 - $215 166%
Auxiant Contracted [320462] $46 - $215 166%
Ebms Contracted [320493] $46 - $215 166%
Edison Health Solutions Contracted [320502] $46 - $215 166%
Healthlink Contracted [320179] $46 - $225 166%
Imagine 360 Contracted [320494] $46 - $215 166%
Mercy Benefit Admin Contracted [320251] $46 - $215 166%
Mercy Benefit Admin [20251] $46 - $215 166%
Preferred Health Plan Contracted [320522] $46 166%
Reflect Health Contracted [320492] $46 - $215 166%
Show-Me Health Administrators Contracted [320483] $46 - $219 166%
Yuzu Health Contracted [320521] $46 - $215 166%
Hope Trust Contracted [320488] $60 216%
Health Choices Contracted [320448] $65 - $97 234%
Health Choices [20448] $65 - $97 234%
Medical Associates Health Contracted [320444] $65 - $97 234%
Federal Medical Center Contracted [320127] $70 - $105 253%
Insurance System Inc Contracted [320465] $70 - $105 253%
Point C Contracted [320238] $70 - $105 253%
Tri State Healthcare Coalition Contracted [320379] $70 - $105 253%
First Health Contracted [320128] $76 - $115 274%
Mercy Mgd Behavioral Health Contracted [320259] $76 - $113 274%
Multiplan Contracted [320270] $76 - $122 274%
Private Health Care Systems Contracted [320320] $76 - $113 274%
Workers Comp [20426] $81 - $130 292%
United Medical Resources Contracted [320454] $107 - $193 386%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 615 New Ballas Road, Saint Louis, MO 63141
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals