CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Mercy Hospital Marietta

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $95
Cash Discount Price: $159
vs. Medicare Baseline: 3.43x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Mercy Hospital Marietta is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.43x the Medicare baseline. Located in 300 Wanda Street, Marietta, OK.

Cash / Self-Pay

$159

Average discount available for prompt cash payment at this facility.

Insurance Median

$95

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: $159 (574%)

Insurance Median: $95 (343%)

Cash: $159 (574% of Medicare)

Ins. Median: $95 (343% 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 343% of the Medicare baseline (a markup of 243%). 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 - $111	87%
Humana	$24 - $51	87%
Medicaid / KanCare	$24	87%
Health Choice Contracted [320166]	$43	155%
Blue Cross Blue Shield	$51 - $78	184%
Cross Timbers Hospice [20098]	$51	184%
Elara Caring Aspire Hospice Contracted [320433]	$51	184%
Elara Caring Aspire Hospice [20433]	$51	184%
Halo Hcr Inc Hospice Contracted [320432]	$51	184%
Halo Hcr Inc Hospice [20432]	$51	184%
Independent Health [20197]	$51	184%
Indian Health Service Contracted [320198]	$51	184%
Kindful Hospice Contracted [320434]	$51	184%
Kindful Hospice [20434]	$51	184%
Medical Associates Health [20444]	$51	184%
Medicare (plans)	$51 - $54	184%
Mercy Hospice Okc [20252]	$51	184%
Tricare	$54	195%
UnitedHealthcare	$54 - $111	195%
Cigna	$56 - $119	202%
Webtpa Contracted [320417]	$67	242%
Aither Health Contracted [320449]	$95 - $135	343%
Mercy Benefit Admin Contracted [320251]	$95 - $143	343%
Quik Trip Contracted [320447]	$95	343%
Show-Me Health Administrators Contracted [320483]	$95	343%
Osma Health Contracted [320292]	$111	400%
United Medical Resources Contracted [320454]	$111 - $143	400%
First Health Contracted [320128]	$112	404%
Benefit Management Contracted [320052]	$119 - $143	429%
Healthcare Highways Plus Contracted [320175]	$119	429%
Auxiant Contracted [320462]	$135 - $143	487%
Ebms Contracted [320493]	$135	487%
Healthlink Contracted [320179]	$135 - $143	487%
Preferred Community Choice Contracted [320311]	$135	487%
Federal Medical Center Contracted [320127]	$143	516%
Healthscope Contracted [320182]	$143	516%
Point C Contracted [320238]	$143	516%
Preferred Health Plan Contracted [320522]	$143	516%
Tri State Healthcare Coalition Contracted [320379]	$143	516%

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 $159.
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 Marietta 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.