CMS Price Transparency Data

Physical therapy (therapeutic exercise)

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

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $117
Cash Discount Price: $131
vs. Medicare Baseline: 4.03x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.03x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

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: $131 (451%)

Insurance Median: $117 (403%)

Cash: $131 (451% of Medicare)

Ins. Median: $117 (403% 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 403% of the Medicare baseline (a markup of 303%). 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	$70	241%
Security Health Plan (Shp)	$72 - $80	248%
Amish/Mennonite	$76	262%
Quartz	$79	272%
Wps Health Insurance	$84 - $93	289%
Cigna	$94 - $102	323%
Health Payment Systems	$96	330%
Humana	$109 - $123	375%
Group Health Cooperative Of Eau Claire	$113 - $131	389%
Network Health Plan	$115	396%
First Health	$117	403%
Molina Healthcare Of Wi	$117	403%
Trilogy	$124	427%
Healtheos By Multiplan Inc.	$128 - $131	440%
Health Partners	$131	451%
Coventry	$132	454%
UnitedHealthcare	$253	871%
Blue Cross Blue Shield	$318 - $477	1094%

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 $131.
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 - Beaver Dam (Mmc-Bd) 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.