CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Merit Health Women's Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $89
  • Cash Discount Price: $95
  • vs. Medicare Baseline: 3.06x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Merit Health Women's Hospital is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.06x the Medicare baseline. Located in 1026 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
$95

Average discount available for prompt cash payment at this facility.

Insurance Median
$89

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: $95 (327%)
Insurance Median: $89 (306%)
Cash: $95 (327% of Medicare)
Ins. Median: $89 (306% 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 306% of the Medicare baseline (a markup of 206%). 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 - $24 38%
Caresource Truecare $24 83%
Magnolia Mcd Ms Chip $24 83%
UnitedHealthcare $24 - $160 83%
Tricare $25 86%
Molina Chip $26 89%
Aetna $27 - $309 93%
Humana $27 93%
Medicare (plans) $27 93%
Node Champva $27 93%
Node Devoted Health Mcr Adv $27 93%
Node First Choice American Health Of Ms Mcr Adv $27 93%
Node Molina Mcr Adv $27 93%
Node Shared Health Of Ms Mcr Adv $27 93%
Node Va $27 93%
Node Vantage Health Mcr Adv $27 93%
Node Windsor Mcr Adv $27 93%
Veterans Eval Services $27 93%
Node First Choice Wellcare Mcr Adv $28 96%
Node Healthy Mississippi Mcr Adv $30 103%
Advanced Health Systems $32 110%
Blue Cross Blue Shield $38 131%
First Choice Preferred $41 141%
Occunet $41 141%
Node Us Dept Of Labor $42 145%
Node First Choice Seven Corners $46 158%
Magnolia Exchange $47 162%
Ms Work Comp $47 162%
Molina Exchange $49 169%
First Choice Lgp $59 203%
Vantage Health $61 210%
Cigna $89 - $96 306%
Self Pay $90 - $97 310%
Trimed Billing Solutions $123 - $132 423%
State Hospital $155 - $168 533%
First Choice Mpcn $184 - $198 633%
First Choice Standard $188 - $203 647%
Coventry First Health $213 - $229 733%
First Choice Ppo Plus $225 - $243 774%
Benefit Management Systems $294 - $375 1012%
First Choice Stratose $327 - $353 1125%
Health Choice Of Mississippi $327 - $353 1125%
Prime Health Services $327 - $353 1125%
Mississippi Department Of Rehabilitation Services $409 - $441 1407%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1026 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals