CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Mercy Hospital Jefferson

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $131
  • Cash Discount Price: $121
  • vs. Medicare Baseline: 4.51x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mercy Hospital Jefferson is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.51x the Medicare baseline. Located in 1400 Us Highway 61, Crystal City, MO.
Cash / Self-Pay
$121

Average discount available for prompt cash payment at this facility.

Insurance Median
$131

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: $121 (416%)
Insurance Median: $131 (451%)
Cash: $121 (416% of Medicare)
Ins. Median: $131 (451% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 451% of the Medicare baseline (a markup of 351%). 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 $12 - $145 41%
Aetna $28 - $184 96%
American Health Advantage Of Mo Mcr [10473] $28 96%
Blue Cross Blue Shield $28 - $312 96%
Cherokee Nation Health Serv Contracted [320066] $28 96%
Cigna $28 - $197 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 - $187 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%
Centivo Contracted [320505] $46 158%
Preferred Health Plan Contracted [320522] $49 169%
Hope Trust Contracted [320488] $63 217%
Health Choices Contracted [320448] $111 - $112 382%
Health Choices [20448] $111 - $112 382%
Medical Associates Health Contracted [320444] $111 - $112 382%
Federal Medical Center Contracted [320127] $120 - $122 413%
Insurance System Inc Contracted [320465] $120 - $122 413%
Point C Contracted [320238] $120 - $122 413%
Tri State Healthcare Coalition Contracted [320379] $120 - $122 413%
Healthlink Contracted [320179] $126 - $225 434%
First Health Contracted [320128] $130 - $133 447%
Mercy Mgd Behavioral Health Contracted [320259] $130 - $131 447%
Multiplan Contracted [320270] $130 - $140 447%
Private Health Care Systems Contracted [320320] $130 - $131 447%
Medica Contracted [320239] $137 471%
Workers Comp [20426] $139 - $150 478%
Ambetter / Centene $145 499%
Home State Health Plan Contracted [320187] $145 499%
Novasys Contracted [320285] $145 499%
Mercy Benefit Admin Contracted [320251] $170 - $209 585%
Mercy Benefit Admin [20251] $170 - $209 585%
United Medical Resources Contracted [320454] $193 664%
Show-Me Health Administrators Contracted [320483] $203 - $213 699%
Aither Health Contracted [320449] $209 719%
Aither Health [20449] $209 719%
Auxiant Contracted [320462] $209 719%
Ebms Contracted [320493] $209 719%
Edison Health Solutions Contracted [320502] $209 719%
Imagine 360 Contracted [320494] $209 719%
Reflect Health Contracted [320492] $209 719%
Yuzu Health Contracted [320521] $209 719%

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