CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Mercy Hospital Washington

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $134
  • Cash Discount Price: $122
  • vs. Medicare Baseline: 4.61x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mercy Hospital Washington is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.61x the Medicare baseline. Located in 901 East 5Th Street, Washington, MO.
Cash / Self-Pay
$122

Average discount available for prompt cash payment at this facility.

Insurance Median
$134

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: $122 (420%)
Insurance Median: $134 (461%)
Cash: $122 (420% of Medicare)
Ins. Median: $134 (461% 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 461% of the Medicare baseline (a markup of 361%). 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 38%
Aetna $25 - $184 86%
American Health Advantage Of Mo Mcr [10473] $26 89%
Blue Cross Blue Shield $26 - $274 89%
Cherokee Nation Health Serv Contracted [320066] $26 89%
Cross Timbers Hospice [20098] $26 89%
Dept Of Veteran Affairs Contracted [320106] $26 89%
Elara Caring Aspire Hospice Contracted [320433] $26 89%
Elara Caring Aspire Hospice [20433] $26 89%
Globalhealth Contracted [320145] $26 89%
Halo Hcr Inc Hospice Contracted [320432] $26 89%
Halo Hcr Inc Hospice [20432] $26 89%
Humana $26 89%
Kindful Hospice Contracted [320434] $26 89%
Kindful Hospice [20434] $26 89%
Medicare (plans) $26 - $206 89%
Mercy Hospice Okc [20252] $26 89%
Pace Of The Ozarks Contracted [320518] $26 89%
Qual Choice Contracted [320325] $26 89%
Tricare $26 89%
UnitedHealthcare $26 - $193 89%
Cigna $28 - $198 96%
Provider Partners Health Plans Contracted [320450] $29 100%
Healthscope Contracted [320182] $33 114%
Centivo Contracted [320505] $44 151%
Preferred Health Plan Contracted [320522] $47 162%
Hope Trust Contracted [320488] $63 217%
Health Choices Contracted [320448] $101 - $124 348%
Health Choices [20448] $101 - $124 348%
Medical Associates Health Contracted [320444] $101 - $124 348%
Federal Medical Center Contracted [320127] $110 - $134 379%
Insurance System Inc Contracted [320465] $110 - $134 379%
Point C Contracted [320238] $110 - $134 379%
Tri State Healthcare Coalition Contracted [320379] $110 - $134 379%
Healthlink Contracted [320179] $115 - $225 396%
First Health Contracted [320128] $118 - $146 406%
Mercy Mgd Behavioral Health Contracted [320259] $118 - $144 406%
Multiplan Contracted [320270] $118 - $154 406%
Private Health Care Systems Contracted [320320] $118 - $144 406%
Workers Comp [20426] $127 - $165 437%
Medica Contracted [320239] $137 471%
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: 901 East 5Th Street, Washington, MO 63090
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals