CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Marshfield Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $141
Cash Discount Price: $143
vs. Medicare Baseline: 4.31x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Marshfield Medical Center is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $143. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 4.31x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$143

Average discount available for prompt cash payment at this facility.

Insurance Median

$141

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$32.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.73 (100%)

Cash / Self-Pay: $143 (437%)

Insurance Median: $141 (431%)

Cash: $143 (437% of Medicare)

Ins. Median: $141 (431% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $32.73 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 431% of the Medicare baseline (a markup of 331%). 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)	$75	229%
Amish/Mennonite	$82	251%
Sanford Health Plan	$82	251%
The Alliance	$104 - $125	318%
Blue Cross Blue Shield	$114 - $132	348%
Security Health Plan (Shp)	$120 - $177	367%
Group Health Cooperative Of Eau Claire	$123 - $138	376%
Besse Forest Products	$128	391%
Molina Healthcare Of Wi	$128	391%
Rice Lake School District	$128	391%
Wps Health Insurance	$132 - $145	403%
Trilogy	$135 - $144	412%
UnitedHealthcare	$136	416%
Medica Of Wi	$139 - $142	425%
Cigna	$141	431%
Healtheos By Multiplan Inc.	$141 - $142	431%
Corvel	$142	434%
First Health	$142	434%
Health Partners	$142	434%
Three Rivers Provider Network (Trpn)	$142	434%
Coventry	$144	440%
Health Smart	$144	440%
Rising Medical Work Comp	$146	446%

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 $143.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97112.

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 97112.
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.