CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Marshfield Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $140
Cash Discount Price: $142
vs. Medicare Baseline: 4.82x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Marshfield Medical Center is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.82x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$142

Average discount available for prompt cash payment at this facility.

Insurance Median

$140

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)

Cash / Self-Pay: $142 (489%)

Insurance Median: $140 (482%)

Cash: $142 (489% of Medicare)

Ins. Median: $140 (482% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $29.06 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 482% of the Medicare baseline (a markup of 382%). 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)	$74	255%
Amish/Mennonite	$82	282%
Sanford Health Plan	$82	282%
The Alliance	$104 - $124	358%
Blue Cross Blue Shield	$113 - $131	389%
Security Health Plan (Shp)	$120 - $177	413%
Group Health Cooperative Of Eau Claire	$122 - $137	420%
Besse Forest Products	$127	437%
Molina Healthcare Of Wi	$127	437%
Rice Lake School District	$127	437%
Wps Health Insurance	$131 - $144	451%
Trilogy	$134 - $143	461%
UnitedHealthcare	$136	468%
Medica Of Wi	$138 - $141	475%
Cigna	$140	482%
Healtheos By Multiplan Inc.	$140 - $142	482%
Corvel	$142	489%
First Health	$142	489%
Health Partners	$142	489%
Three Rivers Provider Network (Trpn)	$142	489%
Coventry	$143	492%
Health Smart	$143	492%
Rising Medical Work Comp	$145	499%

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 $142.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97110.

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 97110.
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.