CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Mercy Hospital Ardmore, Inc
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $145
- Cash Discount Price: $162
- vs. Medicare Baseline: 5.23x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Mercy Hospital Ardmore, Inc is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $162. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 5.23x the Medicare baseline. Located in 1011 14Th Ave Nw, Ardmore, OK.
Cash / Self-Pay
$162
Average discount available for prompt cash payment at this facility.
Insurance Median
$145
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: $162 (584%)
Insurance Median: $145 (523%)
Cash: $162 (584% of Medicare)
Ins. Median: $145 (523% 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 523% of the Medicare baseline (a markup of 423%). 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 |
|---|---|---|
| Aetna | $24 - $169 | 87% |
| Humana | $24 - $184 | 87% |
| Medicaid / KanCare | $24 - $34 | 87% |
| Blue Cross Blue Shield | $25 | 90% |
| Cherokee Nation Health Serv Contracted [320066] | $25 | 90% |
| Cigna | $25 - $162 | 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 - $266 | 90% |
| Mercy Hospice Okc [20252] | $25 | 90% |
| Provider Partners Health Plans Contracted [320450] | $25 | 90% |
| Qual Choice Contracted [320325] | $25 | 90% |
| Tribute Health Plan Mcr Contracted [320338] | $25 | 90% |
| Tricare | $25 | 90% |
| UnitedHealthcare | $25 - $211 | 90% |
| Ambetter / Centene | $34 | 123% |
| Home State Health Plan Contracted [320187] | $34 | 123% |
| Novasys Contracted [320285] | $34 | 123% |
| Workers Comp [20426] | $36 | 130% |
| Community Care Contracted [320080] | $38 - $186 | 137% |
| Health Choice Contracted [320166] | $43 | 155% |
| Healthsmart Preferred Care Contracted [320184] | $55 - $173 | 198% |
| Kempton Contracted [320214] | $55 | 198% |
| Medica Contracted [320239] | $89 - $266 | 321% |
| Healthcare Highways Plus Contracted [320175] | $91 - $160 | 328% |
| Webtpa Contracted [320417] | $98 - $112 | 354% |
| Osma Health Contracted [320292] | $105 - $120 | 379% |
| United Medical Resources Contracted [320454] | $112 - $211 | 404% |
| Aither Health Contracted [320449] | $140 - $160 | 505% |
| Auxiant Contracted [320462] | $140 - $173 | 505% |
| Benefit Management Contracted [320052] | $140 - $173 | 505% |
| Ebms Contracted [320493] | $140 - $160 | 505% |
| Healthlink Contracted [320179] | $140 - $173 | 505% |
| Imagine 360 Contracted [320494] | $140 - $160 | 505% |
| Mercy Benefit Admin Contracted [320251] | $140 - $173 | 505% |
| Quik Trip Contracted [320447] | $140 - $160 | 505% |
| Reflect Health Contracted [320492] | $140 - $160 | 505% |
| Show-Me Health Administrators Contracted [320483] | $140 - $160 | 505% |
| Yuzu Health Contracted [320521] | $140 - $160 | 505% |
| Federal Medical Center Contracted [320127] | $151 - $173 | 545% |
| Healthscope Contracted [320182] | $151 - $173 | 545% |
| Healthsmart Accel Contracted [320183] | $151 - $173 | 545% |
| Point C Contracted [320238] | $151 - $173 | 545% |
| Preferred Health Plan Contracted [320522] | $151 - $173 | 545% |
| Tri State Healthcare Coalition Contracted [320379] | $151 - $173 | 545% |
| First Health Contracted [320128] | $155 - $177 | 559% |
| Globalhealth Contracted [320144] | $158 - $181 | 570% |
| Private Health Care Systems Contracted [320320] | $175 - $213 | 631% |
| Preferred Community Choice Contracted [320311] | $177 - $202 | 639% |
| Multiplan Contracted [320270] | $186 - $239 | 671% |