CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Mercy Hospital Ada

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $73
Cash Discount Price: $115
vs. Medicare Baseline: 2.63x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Mercy Hospital Ada is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.63x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.

Cash / Self-Pay

$115

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$27.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $27.72 (100%)

Cash / Self-Pay: $115 (415%)

Insurance Median: $73 (263%)

Cash: $115 (415% of Medicare)

Ins. Median: $73 (263% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $27.72 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 263% of the Medicare baseline (a markup of 163%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$24 - $175	87%
Humana	$24 - $25	87%
Medicaid / KanCare	$24 - $34	87%
Blue Cross Blue Shield	$25	90%
Cherokee Nation Health Serv Contracted [320066]	$25	90%
Cigna	$25	90%
Cross Timbers Hospice [20098]	$25	90%
Dept Of Veteran Affairs Contracted [320106]	$25	90%
Elara Caring Aspire Hospice Contracted [320433]	$25	90%
Elara Caring Aspire Hospice [20433]	$25	90%
Globalhealth Contracted [320145]	$25	90%
Halo Hcr Inc Hospice Contracted [320432]	$25	90%
Halo Hcr Inc Hospice [20432]	$25	90%
Independent Health [20197]	$25	90%
Indian Health Service Contracted [320198]	$25	90%
Kindful Hospice Contracted [320434]	$25	90%
Kindful Hospice [20434]	$25	90%
Medical Associates Health [20444]	$25	90%
Medicare (plans)	$25 - $233	90%
Mercy Hospice Okc [20252]	$25	90%
Provider Partners Health Plans Contracted [320450]	$25	90%
Qual Choice Contracted [320325]	$25	90%
Tricare	$25	90%
UnitedHealthcare	$25 - $163	90%
Ambetter / Centene	$34	123%
Home State Health Plan Contracted [320187]	$34	123%
Novasys Contracted [320285]	$34	123%
Workers Comp [20426]	$36	130%
Health Choice Contracted [320166]	$43	155%
Healthcare Highways Plus Contracted [320175]	$47 - $175	170%
Webtpa Contracted [320417]	$51 - $98	184%
Osma Health Contracted [320292]	$54 - $105	195%
Healthsmart Preferred Care Contracted [320184]	$55	198%
Kempton Contracted [320214]	$55	198%
Benefit Management Contracted [320052]	$60 - $151	216%
Aither Health Contracted [320449]	$73 - $140	263%
Auxiant Contracted [320462]	$73 - $140	263%
Ebms Contracted [320493]	$73 - $140	263%
Federal Medical Center Contracted [320127]	$73 - $140	263%
Healthlink Contracted [320179]	$73 - $140	263%
Healthscope Contracted [320182]	$73 - $140	263%
Imagine 360 Contracted [320494]	$73 - $140	263%
Mercy Benefit Admin Contracted [320251]	$73 - $151	263%
Point C Contracted [320238]	$73 - $140	263%
Preferred Health Plan Contracted [320522]	$73 - $140	263%
Quik Trip Contracted [320447]	$73 - $140	263%
Reflect Health Contracted [320492]	$73 - $140	263%
Show-Me Health Administrators Contracted [320483]	$73 - $140	263%
United Medical Resources Contracted [320454]	$73 - $163	263%
Yuzu Health Contracted [320521]	$73 - $140	263%
Globalhealth Contracted [320144]	$76 - $147	274%
Medica Contracted [320239]	$95 - $233	343%
First Health Contracted [320128]	$101 - $194	364%
Multiplan Contracted [320270]	$103 - $198	372%
Private Health Care Systems Contracted [320320]	$103 - $198	372%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $115.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97140.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Ada is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97140.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.