CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Froedtert Community Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $105
Cash Discount Price: $96
vs. Medicare Baseline: 3.79x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Froedtert Community Hospital is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.79x the Medicare baseline. Located in 4805 S Moorland Rd, New Berlin, WI.

Cash / Self-Pay

$96

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $96 (346%)

Insurance Median: $105 (379%)

Cash: $96 (346% of Medicare)

Ins. Median: $105 (379% 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 379% of the Medicare baseline (a markup of 279%). 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
Blue Cross Blue Shield	$26 - $79	94%
Care Wisconsin	$26	94%
Community Care	$26	94%
Health Partners	$26 - $114	94%
Humana	$26	94%
Icare	$26	94%
Molina	$26	94%
Network Health Plan	$26 - $109	94%
Security Health Plan Secure Savers	$26	94%
UnitedHealthcare	$26	94%
Chorus Community Health Plan	$69 - $70	249%
Medical College Of Wisconsin	$69 - $70	249%
Centivo	$74 - $88	267%
Cigna	$101 - $103	364%
Common Ground	$104 - $106	375%
Sheboygan Employers Health Network	$104 - $106	375%
Wisconsin Physician Services	$104 - $106	375%
Health Payment Systems	$105 - $108	379%
Trilogy	$112 - $114	404%
Americas Choice	$150 - $153	541%
Healtheos	$150 - $153	541%
Multiplan/Private Healthcare Systems	$150 - $153	541%
First Health Network	$152 - $155	548%

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 $96.
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 Froedtert Community Hospital 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.