CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Marshfield Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $118
Cash Discount Price: $120
vs. Medicare Baseline: 4.26x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Marshfield Medical Center is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.26x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$120

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

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: $120 (433%)

Insurance Median: $118 (426%)

Cash: $120 (433% of Medicare)

Ins. Median: $118 (426% 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 426% of the Medicare baseline (a markup of 326%). 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)	$63	227%
Amish/Mennonite	$69	249%
Sanford Health Plan	$69	249%
The Alliance	$88 - $105	317%
Blue Cross Blue Shield	$96 - $111	346%
Group Health Cooperative Of Eau Claire	$103 - $116	372%
Besse Forest Products	$107	386%
Molina Healthcare Of Wi	$107	386%
Rice Lake School District	$107	386%
Wps Health Insurance	$111 - $122	400%
Trilogy	$113 - $121	408%
UnitedHealthcare	$115	415%
Medica Of Wi	$117 - $119	422%
Cigna	$118	426%
Healtheos By Multiplan Inc.	$118 - $120	426%
Corvel	$120	433%
First Health	$120	433%
Health Partners	$120	433%
Security Health Plan (Shp)	$120 - $177	433%
Three Rivers Provider Network (Trpn)	$120	433%
Coventry	$121	437%
Health Smart	$121	437%
Rising Medical Work Comp	$122	440%

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 $120.
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 Marshfield Medical Center 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.