CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Mercy Hospital Jefferson

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $87
  • Cash Discount Price: $108
  • vs. Medicare Baseline: 3.14x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Mercy Hospital Jefferson is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.14x the Medicare baseline. Located in 1400 Us Highway 61, Crystal City, MO.
Cash / Self-Pay
$108

Average discount available for prompt cash payment at this facility.

Insurance Median
$87

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: $108 (390%)
Insurance Median: $87 (314%)
Cash: $108 (390% of Medicare)
Ins. Median: $87 (314% 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 314% of the Medicare baseline (a markup of 214%). 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
Medicaid / KanCare $11 - $145 40%
Aetna $25 - $184 90%
American Health Advantage Of Mo Mcr [10473] $26 94%
Blue Cross Blue Shield $26 - $312 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 - $166 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 - $197 97%
Provider Partners Health Plans Contracted [320450] $29 105%
Healthscope Contracted [320182] $33 119%
Medica Contracted [320239] $43 - $137 155%
Centivo Contracted [320505] $44 159%
Ambetter / Centene $45 - $145 162%
Home State Health Plan Contracted [320187] $45 - $145 162%
Novasys Contracted [320285] $45 - $145 162%
Preferred Health Plan Contracted [320522] $46 166%
Hope Trust Contracted [320488] $60 216%
Aither Health Contracted [320449] $65 - $209 234%
Aither Health [20449] $65 - $209 234%
Auxiant Contracted [320462] $65 - $209 234%
Ebms Contracted [320493] $65 - $209 234%
Edison Health Solutions Contracted [320502] $65 - $209 234%
Healthlink Contracted [320179] $65 - $225 234%
Imagine 360 Contracted [320494] $65 - $209 234%
Mercy Benefit Admin Contracted [320251] $65 - $209 234%
Mercy Benefit Admin [20251] $65 - $209 234%
Reflect Health Contracted [320492] $65 - $209 234%
Show-Me Health Administrators Contracted [320483] $65 - $213 234%
Yuzu Health Contracted [320521] $65 - $209 234%
Health Choices Contracted [320448] $100 361%
Health Choices [20448] $100 361%
Medical Associates Health Contracted [320444] $100 361%
Federal Medical Center Contracted [320127] $108 390%
Insurance System Inc Contracted [320465] $108 390%
Point C Contracted [320238] $108 390%
Tri State Healthcare Coalition Contracted [320379] $108 390%
First Health Contracted [320128] $116 - $118 418%
Mercy Mgd Behavioral Health Contracted [320259] $116 418%
Multiplan Contracted [320270] $116 - $124 418%
Private Health Care Systems Contracted [320320] $116 418%
United Medical Resources Contracted [320454] $118 - $193 426%
Workers Comp [20426] $124 - $133 447%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 Us Highway 61, Crystal City, MO 63019
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals