CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Mercy Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $72
  • Cash Discount Price: $157
  • vs. Medicare Baseline: 2.20x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Mercy Medical Center is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $157. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.20x the Medicare baseline. Located in 1320 Mercy Drive Nw, Canton, OH.
Cash / Self-Pay
$157

Average discount available for prompt cash payment at this facility.

Insurance Median
$72

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: $157 (480%)
Insurance Median: $72 (220%)
Cash: $157 (480% of Medicare)
Ins. Median: $72 (220% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 220% of the Medicare baseline (a markup of 120%). 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
United $18 - $238 55%
Buckeye $19 - $71 58%
Caresource $19 - $71 58%
Amerihealth $20 - $76 61%
Molina $20 - $72 61%
Summacare $20 - $151 61%
Aetna $28 - $242 86%
Blue Cross Blue Shield $31 - $155 95%
Cigna $31 - $126 95%
Humana $31 - $41 95%
The Health Plan $31 - $242 95%
Communicare $32 - $43 98%
Mmo $32 - $151 98%
Perennial Health $33 - $45 101%
Zing Health $34 - $73 104%
Aultcare $35 - $99 107%
Oscar $58 - $93 177%
Ohcp $84 - $118 257%
Cc Ehp $97 - $98 296%
Omas $108 - $121 330%
Amish Community Aid Plan $109 - $121 333%
Immergrun $121 - $162 370%
Phphi $130 - $145 397%
Ohio Healthy $131 400%
Php $145 443%
Gms $151 - $169 461%
Medical Benefit Corp $169 516%
Consociate Health $182 556%
Multiplan $194 - $218 593%
Frontpath $218 666%
Managed Care Services $218 666%
Tertiary Care Network $218 666%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 Mercy Drive Nw, Canton, OH 44708
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals