CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Mercy Hospital Aurora

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $90
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 3.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mercy Hospital Aurora is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.10x the Medicare baseline. Located in 500 Porter Avenue, Aurora, MO.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$90

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: $69 (237%)
Insurance Median: $90 (310%)
Cash: $69 (237% of Medicare)
Ins. Median: $90 (310% 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 310% of the Medicare baseline (a markup of 210%). 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 $22 - $54 76%
Medicare (plans) $28 - $31 96%
Aetna $30 - $94 103%
Blue Cross Blue Shield $30 - $106 103%
Cherokee Nation Health Serv Contracted [320066] $30 103%
Cigna $30 - $90 103%
Cross Timbers Hospice [20098] $30 103%
Elara Caring Aspire Hospice [20433] $30 103%
Globalhealth Contracted [320145] $30 103%
Halo Hcr Inc Hospice Contracted [320432] $30 103%
Halo Hcr Inc Hospice [20432] $30 103%
Humana $30 - $90 103%
Indian Health Service Contracted [320198] $30 103%
Kindful Hospice Contracted [320434] $30 103%
Kindful Hospice [20434] $30 103%
Medical Associates Health Contracted [320444] $30 103%
Mercy Hospice Okc [20252] $30 103%
Mercy Mgd Behavioral Health Contracted [320259] $30 103%
Pace Of The Ozarks Contracted [320518] $30 103%
Provider Partners Health Plans Contracted [320450] $30 103%
Qual Choice Contracted [320325] $30 103%
UnitedHealthcare $30 - $101 103%
Dept Of Veteran Affairs Contracted [320106] $31 107%
Tricare $31 107%
Healthscope Contracted [320182] $39 134%
Centivo Contracted [320505] $42 145%
Administrative Payor Contracted [320005] $48 165%
Ambetter / Centene $54 186%
Home State Health Plan Contracted [320187] $54 186%
Novasys Contracted [320285] $54 186%
Healthlink Contracted [320179] $69 - $95 237%
Preferred Health Plan Contracted [320522] $69 237%
Health Systems Inc Contracted [320174] $85 292%
Insurance System Inc Contracted [320465] $85 292%
Point C Contracted [320238] $85 - $90 292%
Point C [20238] $85 292%
Workers Comp [20426] $85 - $90 292%
90 Degree Benefits Contracted [320436] $90 310%
Aither Health Contracted [320449] $90 310%
American Healthcare Alliance Contracted [320020] $90 310%
Auxiant Contracted [320462] $90 310%
Benefit Management Contracted [320052] $90 310%
Ebms Contracted [320493] $90 310%
Edison Health Solutions Contracted [320502] $90 310%
Evolutions Health Care Contracted [320124] $90 310%
First Health Contracted [320128] $90 310%
Imagine 360 Contracted [320494] $90 310%
Medica Contracted [320239] $90 310%
Mercy Benefit Admin Contracted [320251] $90 310%
Reflect Health Contracted [320492] $90 310%
Show-Me Health Administrators Contracted [320483] $90 310%
United Medical Resources Contracted [320454] $90 - $93 310%
Yuzu Health Contracted [320521] $90 310%
Usa Managed Care Org Contracted [320429] $93 320%
Multiplan Contracted [320270] $101 348%
Private Health Care Systems Contracted [320320] $101 348%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 Porter Avenue, Aurora, MO 65605
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals