CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Gundersen Lutheran Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $98
Cash Discount Price: $62
vs. Medicare Baseline: 3.54x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Gundersen Lutheran Medical Center is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.54x the Medicare baseline. Located in 1910 South Ave, La Crosse, WI.

Cash / Self-Pay

$62

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $62 (224%)

Insurance Median: $98 (354%)

Cash: $62 (224% of Medicare)

Ins. Median: $98 (354% 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 354% of the Medicare baseline (a markup of 254%). 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
Amerigroup	$15 - $35	54%
Blue Cross Blue Shield	$15 - $486	54%
Group Health Eau Claire	$15 - $148	54%
Group Health Of South Central	$15 - $131	54%
Icare	$15 - $35	54%
Iowa Total Care	$15	54%
Managed Health Service	$15	54%
Molina Health	$15	54%
UnitedHealthcare	$15 - $134	54%
Aetna	$35 - $156	126%
Medical Associates	$35 - $123	126%
Ucare	$35 - $131	126%
Medica	$55 - $126	198%
Dean Health Plan	$69	249%
Quartz	$69	249%
Health Partners	$82 - $145	296%
Alliance	$108 - $143	390%
Midland Choice	$123	444%
Claim Doc Llc	$131	473%
Wps Narrow Network	$133	480%
Cigna	$134	483%
Wps - Arise	$135	487%
Aspirus Arise Health	$136	491%
Allied National General	$139	501%
Preferred One	$139	501%
Wps Statewide	$139	501%
Coventry Health Care	$156	563%
Humana	$156	563%
Multiplan/Healtheos	$157	566%

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 $62.
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 Gundersen Lutheran Medical Center 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.