CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Marshfield Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $129
Cash Discount Price: $130
vs. Medicare Baseline: 3.82x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Marshfield Medical Center is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.82x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$130

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$33.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $33.73 (100%)

Cash / Self-Pay: $130 (385%)

Insurance Median: $129 (382%)

Cash: $130 (385% of Medicare)

Ins. Median: $129 (382% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $33.73 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 382% of the Medicare baseline (a markup of 282%). 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
Family Health Center (Fhc)	$68	202%
Amish/Mennonite	$75	222%
Sanford Health Plan	$75	222%
The Alliance	$95 - $114	282%
Blue Cross Blue Shield	$104 - $121	308%
Group Health Cooperative Of Eau Claire	$112 - $126	332%
Besse Forest Products	$116	344%
Molina Healthcare Of Wi	$116	344%
Rice Lake School District	$116	344%
Security Health Plan (Shp)	$120 - $177	356%
Wps Health Insurance	$121 - $132	359%
Trilogy	$123 - $132	365%
UnitedHealthcare	$125	371%
Medica Of Wi	$127 - $130	377%
Cigna	$129	382%
Healtheos By Multiplan Inc.	$129 - $130	382%
Corvel	$130	385%
First Health	$130	385%
Health Partners	$130	385%
Three Rivers Provider Network (Trpn)	$130	385%
Coventry	$132	391%
Health Smart	$132	391%
Rising Medical Work Comp	$133	394%

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 $130.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97750.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Marshfield Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97750.
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.