CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: UW Health

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $74
Cash Discount Price: $40
vs. Medicare Baseline: 2.67x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at UW Health is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 2.67x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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: $40 (144%)

Insurance Median: $74 (267%)

Cash: $40 (144% of Medicare)

Ins. Median: $74 (267% 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 267% of the Medicare baseline (a markup of 167%). 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	$18 - $132	65%
Blue Cross Blue Shield	$18 - $90	65%
Medicaid / KanCare	$18	65%
UnitedHealthcare	$26 - $142	94%
Humana	$27	97%
Medicare (plans)	$27 - $185	97%
Mychoice Wi Medical Adv	$27	97%
Quartz Aso	$34 - $58	123%
Quartz Fully Insured	$34 - $52	123%
Wps	$43	155%
Beloit Healt System	$50 - $165	180%
Alliance Premier Network	$55 - $100	198%
Workers Comp	$55	198%
The Alliance	$60 - $128	216%
Mercy Care	$61	220%
Ecoh	$65 - $144	234%
Hfn	$65 - $144	234%
Wps Ppo	$124 - $141	447%
Cigna	$128 - $146	462%
Mercycare	$150 - $170	541%
First Health/Coventry	$158 - $179	570%
Health Payment Systems	$188 - $213	678%
Healthsmart	$188 - $213	678%
Sheboygan Employers Health Network	$200 - $227	722%
Multiplan	$224 - $254	808%

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 $40.
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 UW Health 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.