CMS Price Transparency Data

Physical therapy (gait training)

Facility: Gundersen St Josephs Hospital and Clinics

Billing Code: 97116 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$129
about 4.4× the $29 Medicare rate · typically $36–$172
modeled estimate · not a bill or quote
What this hospital charges insurers
$117
About the fair price
about $12 under the fair price · 4.0× Medicare
Medicare pays $29 Fair price $129 This hospital $117 Cash price $110 Hospital's list price $190

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $25 Priciest $117

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Physical therapy (gait training) is about $129 (about 4.4× the $29 Medicare rate). Gundersen St Josephs Hospital and Clinics charges insurers about $117, or about $110 in cash — about the fair price. Located in Hillsboro, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $101 - $133 348%
Blue Cross Blue Shieldmajor $74 - $352 255%
Aetnamajor $180 619%
Cignamajor $156 537%
Humanamajor $162 557%
Amerigroup $12 41%
Quartz $104 358%
Security Health Plan $37 127%
UCare $99 - $152 341%
+ 4 smaller / regional plans $74 - $161
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 400 Water Ave, Hillsboro, WI 54634
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals