CMS Price Transparency Data

Physical therapy (manual therapy)

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

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $109
Cash Discount Price: $122
vs. Medicare Baseline: 3.93x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.93x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$122

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $122 (440%)

Insurance Median: $109 (393%)

Cash: $122 (440% of Medicare)

Ins. Median: $109 (393% 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 393% of the Medicare baseline (a markup of 293%). 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	$65	234%
Security Health Plan (Shp)	$67 - $74	242%
Amish/Mennonite	$70	253%
Quartz	$73	263%
Wps Health Insurance	$77 - $86	278%
Cigna	$87 - $95	314%
Health Payment Systems	$89	321%
Humana	$101 - $114	364%
Group Health Cooperative Of Eau Claire	$105 - $122	379%
Network Health Plan	$107	386%
First Health	$109	393%
Molina Healthcare Of Wi	$109	393%
Trilogy	$115	415%
Healtheos By Multiplan Inc.	$119 - $122	429%
Health Partners	$122	440%
Coventry	$123	444%
UnitedHealthcare	$253	913%
Blue Cross Blue Shield	$318 - $477	1147%

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 $122.
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 - Beaver Dam (Mmc-Bd) 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.