CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $120
Cash Discount Price: $134
vs. Medicare Baseline: 3.56x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.56x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$134

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

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: $134 (397%)

Insurance Median: $120 (356%)

Cash: $134 (397% of Medicare)

Ins. Median: $120 (356% 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 356% of the Medicare baseline (a markup of 256%). 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
The Alliance	$72	213%
Security Health Plan (Shp)	$73 - $81	216%
Amish/Mennonite	$78	231%
Quartz	$80	237%
Wps Health Insurance	$95 - $97	282%
Cigna	$96 - $104	285%
Health Payment Systems	$98	291%
Humana	$111 - $125	329%
Group Health Cooperative Of Eau Claire	$116 - $134	344%
Network Health Plan	$118	350%
First Health	$120	356%
Molina Healthcare Of Wi	$120	356%
Trilogy	$127	377%
Healtheos By Multiplan Inc.	$131 - $134	388%
Health Partners	$134	397%
Coventry	$135	400%
UnitedHealthcare	$253	750%
Blue Cross Blue Shield	$318 - $477	943%

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 $134.
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 - Beaver Dam (Mmc-Bd) 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.