CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Mercy Hospital Southeast

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $37
  • Cash Discount Price: $115
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Mercy Hospital Southeast is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.13x the Medicare baseline. Located in 1701 Lacey St, Cape Girardeau, MO.
Cash / Self-Pay
$115

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$32.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.73 (100%)
Cash / Self-Pay: $115 (351%)
Insurance Median: $37 (113%)
Cash: $115 (351% of Medicare)
Ins. Median: $37 (113% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $32.73 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 $12 - $113 37%
Medicaid / KanCare $12 - $51 37%
Auxiant Contracted [320462] $29 - $59 89%
Blue Cross Blue Shield $29 - $168 89%
Cross Timbers Hospice [20098] $29 89%
Dept Of Veteran Affairs Contracted [320106] $29 89%
Elara Caring Aspire Hospice Contracted [320433] $29 89%
Elara Caring Aspire Hospice [20433] $29 89%
Halo Hcr Inc Hospice Contracted [320432] $29 89%
Halo Hcr Inc Hospice [20432] $29 89%
Healthlink Contracted [320179] $29 - $220 89%
Humana $29 - $150 89%
Imagine 360 Contracted [320494] $29 89%
Kindful Hospice Contracted [320434] $29 89%
Kindful Hospice [20434] $29 89%
Medicare (plans) $29 - $31 89%
Mercy Benefit Admin Contracted [320251] $29 - $120 89%
Mercy Hospice Okc [20252] $29 89%
Pace Of The Ozarks Contracted [320518] $29 89%
Tricare $29 89%
Ambetter / Centene $30 92%
American Health Advantage Of Mo Mcr Hmo Contracted [320264] $30 92%
Home State Health Plan Contracted [320187] $30 92%
Hope Trust Contracted [320488] $30 92%
UnitedHealthcare $30 - $44 92%
United Medical Resources Contracted [320454] $33 101%
Provider Partners Health Plans Contracted [320450] $34 104%
Consociate Consolidated Health Contracted [320490] $41 - $66 125%
Centivo Contracted [320505] $49 150%
Ebms Contracted [320493] $49 150%
Preferred Health Plan Contracted [320522] $52 159%
Reflect Health Contracted [320492] $53 162%
First Health Contracted [320128] $113 345%
Health Alliance Contracted [320164] $115 351%
Aither Health Contracted [320449] $120 367%
Edison Health Solutions Contracted [320502] $120 367%
Mercy Benefit Admin [20251] $120 367%
Yuzu Health Contracted [320521] $120 367%
Workers Comp [20426] $133 - $142 406%
Multiplan Contracted [320270] $142 434%
Private Health Care Systems Contracted [320320] $142 434%
Cigna $286 874%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Lacey St, Cape Girardeau, MO 63701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals