CMS Price Transparency Data
Physical therapy (therapeutic exercise)
Facility: Mercy Hospital St Louis
Billing Code: 97110 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97110
- Insurance Median: $46
- Cash Discount Price: $90
- vs. Medicare Baseline: 1.58x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mercy Hospital St Louis is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.58x the Medicare baseline. Located in 615 New Ballas Road, Saint Louis, MO.
Cash / Self-Pay
$90
Average discount available for prompt cash payment at this facility.
Insurance Median
$46
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: $90 (310%)
Insurance Median: $46 (158%)
Cash: $90 (310% of Medicare)
Ins. Median: $46 (158% 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.
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 | $4 - $1,201 | 14% |
| Medicaid / KanCare | $4 - $145 | 14% |
| Ambetter / Centene | $16 - $145 | 55% |
| Home State Health Plan Contracted [320187] | $16 - $145 | 55% |
| Medica Contracted [320239] | $16 - $137 | 55% |
| Novasys Contracted [320285] | $16 - $145 | 55% |
| Blue Cross Blue Shield | $25 - $274 | 86% |
| Aither Health Contracted [320449] | $26 - $215 | 89% |
| Aither Health [20449] | $26 - $215 | 89% |
| Auxiant Contracted [320462] | $26 - $215 | 89% |
| Ebms Contracted [320493] | $26 - $215 | 89% |
| Edison Health Solutions Contracted [320502] | $26 - $215 | 89% |
| Healthlink Contracted [320179] | $26 - $225 | 89% |
| Imagine 360 Contracted [320494] | $26 - $215 | 89% |
| Mercy Benefit Admin Contracted [320251] | $26 - $215 | 89% |
| Mercy Benefit Admin [20251] | $26 - $215 | 89% |
| Reflect Health Contracted [320492] | $26 - $215 | 89% |
| Show-Me Health Administrators Contracted [320483] | $26 - $219 | 89% |
| Yuzu Health Contracted [320521] | $26 - $215 | 89% |
| Cigna | $27 - $1,232 | 93% |
| American Health Advantage Of Mo Mcr [10473] | $28 | 96% |
| Cherokee Nation Health Serv Contracted [320066] | $28 | 96% |
| Cross Timbers Hospice [20098] | $28 | 96% |
| Dept Of Veteran Affairs Contracted [320106] | $28 | 96% |
| Elara Caring Aspire Hospice Contracted [320433] | $28 | 96% |
| Elara Caring Aspire Hospice [20433] | $28 | 96% |
| Globalhealth Contracted [320145] | $28 | 96% |
| Halo Hcr Inc Hospice Contracted [320432] | $28 | 96% |
| Halo Hcr Inc Hospice [20432] | $28 | 96% |
| Humana | $28 | 96% |
| Kindful Hospice Contracted [320434] | $28 | 96% |
| Kindful Hospice [20434] | $28 | 96% |
| Medicare (plans) | $28 - $161 | 96% |
| Mercy Hospice Okc [20252] | $28 | 96% |
| Pace Of The Ozarks Contracted [320518] | $28 | 96% |
| Qual Choice Contracted [320325] | $28 | 96% |
| Tricare | $28 | 96% |
| UnitedHealthcare | $28 - $193 | 96% |
| Provider Partners Health Plans Contracted [320450] | $30 | 103% |
| Healthscope Contracted [320182] | $35 | 120% |
| Health Choices Contracted [320448] | $36 - $97 | 124% |
| Health Choices [20448] | $36 - $97 | 124% |
| Medical Associates Health Contracted [320444] | $36 - $97 | 124% |
| Federal Medical Center Contracted [320127] | $39 - $105 | 134% |
| Insurance System Inc Contracted [320465] | $39 - $105 | 134% |
| Point C Contracted [320238] | $39 - $105 | 134% |
| Tri State Healthcare Coalition Contracted [320379] | $39 - $105 | 134% |
| First Health Contracted [320128] | $42 - $114 | 145% |
| Mercy Mgd Behavioral Health Contracted [320259] | $42 - $113 | 145% |
| Multiplan Contracted [320270] | $42 - $121 | 145% |
| Private Health Care Systems Contracted [320320] | $42 - $113 | 145% |
| Workers Comp [20426] | $45 - $129 | 155% |
| Centivo Contracted [320505] | $46 | 158% |
| Hope Trust Contracted [320488] | $46 - $63 | 158% |
| Preferred Health Plan Contracted [320522] | $46 - $49 | 158% |
| United Medical Resources Contracted [320454] | $107 - $193 | 368% |