CMS Price Transparency Data
Physical therapy (therapeutic exercise)
Facility: Mercy Hospital Oklahoma City, Inc
Billing Code: 97110 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97110
- Insurance Median: $88
- Cash Discount Price: $151
- vs. Medicare Baseline: 3.03x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mercy Hospital Oklahoma City, Inc is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.03x the Medicare baseline. Located in 4300 West Memorial Road, Oklahoma City, OK.
Cash / Self-Pay
$151
Average discount available for prompt cash payment at this facility.
Insurance Median
$88
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: $151 (520%)
Insurance Median: $88 (303%)
Cash: $151 (520% of Medicare)
Ins. Median: $88 (303% 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 303% of the Medicare baseline (a markup of 203%). 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.
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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 - $37 | 76% |
| Tricare | $25 - $27 | 86% |
| Aetna | $26 - $238 | 89% |
| Humana | $26 - $227 | 89% |
| Blue Cross Blue Shield | $27 | 93% |
| Champva [20065] | $27 | 93% |
| Cherokee Nation Health Serv Contracted [320066] | $27 | 93% |
| Cross Timbers Hospice [20098] | $27 | 93% |
| Dept Of Veteran Affairs Contracted [320106] | $27 | 93% |
| Elara Caring Aspire Hospice Contracted [320433] | $27 | 93% |
| Elara Caring Aspire Hospice [20433] | $27 | 93% |
| Globalhealth Contracted [320145] | $27 | 93% |
| Halo Hcr Inc Hospice Contracted [320432] | $27 | 93% |
| Halo Hcr Inc Hospice [20432] | $27 | 93% |
| Indian Health Service Contracted [320198] | $27 | 93% |
| Kindful Hospice Contracted [320434] | $27 | 93% |
| Kindful Hospice [20434] | $27 | 93% |
| Longevity Health Plan [10477] | $27 | 93% |
| Medicare (plans) | $27 - $29 | 93% |
| Mercy Hospice Okc [20252] | $27 | 93% |
| Mercy Rehab Hospital Contracted [320260] | $27 | 93% |
| Provider Partners Health Plans Contracted [320450] | $27 | 93% |
| Qual Choice Contracted [320325] | $27 | 93% |
| UnitedHealthcare | $27 - $144 | 93% |
| Cigna | $28 - $197 | 96% |
| Amg Spec Hosp Edmond [20034] | $29 | 100% |
| Ambetter / Centene | $37 | 127% |
| Home State Health Plan Contracted [320187] | $37 | 127% |
| Novasys Contracted [320285] | $37 | 127% |
| Workers Comp [20426] | $39 | 134% |
| Community Care Contracted [320080] | $41 - $230 | 141% |
| Health Choice Contracted [320166] | $41 | 141% |
| Medica Contracted [320239] | $43 - $104 | 148% |
| Healthcare Highways Plus Contracted [320175] | $53 - $197 | 182% |
| Webtpa Contracted [320417] | $57 - $138 | 196% |
| Healthsmart Preferred Care Contracted [320184] | $60 - $214 | 206% |
| Kempton Contracted [320214] | $60 | 206% |
| Osma Health Contracted [320292] | $61 - $148 | 210% |
| Aither Health Contracted [320449] | $82 - $197 | 282% |
| Auxiant Contracted [320462] | $82 - $214 | 282% |
| Benefit Management Contracted [320052] | $82 - $214 | 282% |
| Ebms Contracted [320493] | $82 - $197 | 282% |
| Healthlink Contracted [320179] | $82 - $214 | 282% |
| Imagine 360 Contracted [320494] | $82 - $197 | 282% |
| Mercy Benefit Admin Contracted [320251] | $82 - $214 | 282% |
| Quik Trip Contracted [320447] | $82 - $197 | 282% |
| Reflect Health Contracted [320492] | $82 - $197 | 282% |
| Show-Me Health Administrators Contracted [320483] | $82 - $197 | 282% |
| Yuzu Health Contracted [320521] | $82 - $197 | 282% |
| First Health Contracted [320128] | $84 - $203 | 289% |
| Federal Medical Center Contracted [320127] | $88 - $214 | 303% |
| Healthscope Contracted [320182] | $88 - $214 | 303% |
| Healthsmart Accel Contracted [320183] | $88 - $214 | 303% |
| Point C Contracted [320238] | $88 - $214 | 303% |
| Preferred Health Plan Contracted [320522] | $88 - $214 | 303% |
| Private Health Care Systems Contracted [320320] | $88 - $230 | 303% |
| Tri State Healthcare Coalition Contracted [320379] | $88 - $214 | 303% |
| United Medical Resources Contracted [320454] | $88 - $214 | 303% |
| Multiplan Contracted [320270] | $95 - $296 | 327% |
| Globalhealth Contracted [320144] | $97 - $234 | 334% |
| Preferred Community Choice Contracted [320311] | $103 - $250 | 354% |
| Centralink Contracted [320480] | $136 - $329 | 468% |