CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Mercy Hospital Ada

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $119
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 4.09x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mercy Hospital Ada is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.09x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$119

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: $129 (444%)
Insurance Median: $119 (409%)
Cash: $129 (444% of Medicare)
Ins. Median: $119 (409% 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 409% of the Medicare baseline (a markup of 309%). 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
Aetna $26 - $150 89%
Humana $26 - $27 89%
Medicaid / KanCare $26 - $37 89%
Blue Cross Blue Shield $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%
Independent Health [20197] $27 93%
Indian Health Service Contracted [320198] $27 93%
Kindful Hospice Contracted [320434] $27 93%
Kindful Hospice [20434] $27 93%
Medical Associates Health [20444] $27 93%
Medicare (plans) $27 - $199 93%
Mercy Hospice Okc [20252] $27 93%
Provider Partners Health Plans Contracted [320450] $27 93%
Qual Choice Contracted [320325] $27 93%
Tricare $27 93%
UnitedHealthcare $27 - $139 93%
Cigna $28 96%
Ambetter / Centene $37 127%
Home State Health Plan Contracted [320187] $37 127%
Novasys Contracted [320285] $37 127%
Workers Comp [20426] $39 134%
Health Choice Contracted [320166] $45 155%
Healthsmart Preferred Care Contracted [320184] $60 206%
Kempton Contracted [320214] $60 206%
Healthcare Highways Plus Contracted [320175] $78 - $149 268%
Webtpa Contracted [320417] $84 289%
Osma Health Contracted [320292] $90 310%
Medica Contracted [320239] $95 - $199 327%
Benefit Management Contracted [320052] $100 - $129 344%
Aither Health Contracted [320449] $119 409%
Auxiant Contracted [320462] $119 409%
Ebms Contracted [320493] $119 409%
Federal Medical Center Contracted [320127] $119 409%
Healthlink Contracted [320179] $119 409%
Healthscope Contracted [320182] $119 409%
Imagine 360 Contracted [320494] $119 409%
Mercy Benefit Admin Contracted [320251] $119 - $129 409%
Point C Contracted [320238] $119 409%
Preferred Health Plan Contracted [320522] $119 409%
Quik Trip Contracted [320447] $119 409%
Reflect Health Contracted [320492] $119 409%
Show-Me Health Administrators Contracted [320483] $119 409%
United Medical Resources Contracted [320454] $119 - $139 409%
Yuzu Health Contracted [320521] $119 409%
Globalhealth Contracted [320144] $125 430%
First Health Contracted [320128] $165 568%
Multiplan Contracted [320270] $169 582%
Private Health Care Systems Contracted [320320] $169 582%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 North Monte Vista, Ada, OK 74820
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals