CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Mercy Hospital Lincoln

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $115
  • Cash Discount Price: $100
  • vs. Medicare Baseline: 3.96x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mercy Hospital Lincoln is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.96x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.
Cash / Self-Pay
$100

Average discount available for prompt cash payment at this facility.

Insurance Median
$115

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: $100 (344%)
Insurance Median: $115 (396%)
Cash: $100 (344% of Medicare)
Ins. Median: $115 (396% 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 396% of the Medicare baseline (a markup of 296%). 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 $10 - $71 34%
Aetna $23 - $102 79%
Medicare (plans) $33 - $155 114%
Tricare $33 114%
UnitedHealthcare $34 - $102 117%
American Health Advantage Of Mo Mcr [10473] $36 124%
Blue Cross Blue Shield $36 - $202 124%
Cherokee Nation Health Serv Contracted [320066] $36 124%
Cross Timbers Hospice [20098] $36 124%
Dept Of Veteran Affairs Contracted [320106] $36 124%
Elara Caring Aspire Hospice Contracted [320433] $36 124%
Elara Caring Aspire Hospice [20433] $36 124%
Globalhealth Contracted [320145] $36 124%
Halo Hcr Inc Hospice Contracted [320432] $36 124%
Halo Hcr Inc Hospice [20432] $36 124%
Humana $36 - $140 124%
Indian Health Service Contracted [320198] $36 124%
Kindful Hospice Contracted [320434] $36 124%
Kindful Hospice [20434] $36 124%
Mercy Hospice Okc [20252] $36 124%
Pace Of The Ozarks Contracted [320518] $36 124%
Provider Partners Health Plans Contracted [320450] $36 124%
Qual Choice Contracted [320325] $36 124%
Cigna $38 - $129 131%
Centivo Contracted [320505] $56 193%
Medica Contracted [320239] $64 - $65 220%
Ambetter / Centene $70 - $71 241%
Home State Health Plan Contracted [320187] $70 - $71 241%
Novasys Contracted [320285] $70 - $71 241%
Hope Trust Contracted [320488] $76 - $77 262%
Health Choices Contracted [320448] $92 - $93 317%
Health Choices [20448] $92 - $93 317%
Medical Associates Health Contracted [320444] $92 - $93 317%
First Health Contracted [320128] $100 - $116 344%
United Medical Resources Contracted [320454] $101 - $102 348%
Mercy Mgd Behavioral Health Contracted [320259] $115 - $116 396%
Multiplan Contracted [320270] $115 - $116 396%
Private Health Care Systems Contracted [320320] $115 - $116 396%
Workers Comp [20426] $115 - $124 396%
Healthlink Contracted [320179] $124 - $138 427%
Aither Health Contracted [320449] $130 - $132 447%
Aither Health [20449] $130 - $132 447%
Auxiant Contracted [320462] $130 - $132 447%
Ebms Contracted [320493] $130 - $132 447%
Edison Health Solutions Contracted [320502] $130 - $132 447%
Federal Medical Center Contracted [320127] $130 - $132 447%
Imagine 360 Contracted [320494] $130 - $132 447%
Insurance System Inc Contracted [320465] $130 - $132 447%
Mercy Benefit Admin Contracted [320251] $130 - $132 447%
Mercy Benefit Admin [20251] $130 - $132 447%
Point C Contracted [320238] $130 - $132 447%
Preferred Health Plan Contracted [320522] $130 - $132 447%
Reflect Health Contracted [320492] $130 - $132 447%
Show-Me Health Administrators Contracted [320483] $130 - $132 447%
Tri State Healthcare Coalition Contracted [320379] $130 - $132 447%
Yuzu Health Contracted [320521] $130 - $132 447%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 East Cherry Street, Troy, MO 63379
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals