CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Crossing Rivers Health Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $165
Cash Discount Price: $174
vs. Medicare Baseline: 5.68x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Crossing Rivers Health Medical Center is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.68x the Medicare baseline. Located in 37868 Us Hwy 18, Prairie Du Chien, WI.

Cash / Self-Pay

$174

Average discount available for prompt cash payment at this facility.

Insurance Median

$165

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: $174 (599%)

Insurance Median: $165 (568%)

Cash: $174 (599% of Medicare)

Ins. Median: $165 (568% 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 568% of the Medicare baseline (a markup of 468%). 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 Mcr Adv	$73	251%
Blue Cross Blue Shield	$73 - $169	251%
Security Hlth Mcr Adv	$73	251%
UnitedHealthcare	$73	251%
Amerigroup Mcaid-All Other Plans	$74	255%
Humana	$74 - $167	255%
Iowa Total Care Mcaid-All Plans	$74	255%
Quartz - All Plans	$139	478%
Dean Health Plan - All Plans	$165	568%
Medica Comm - All Other Plans	$165	568%
Medica Hp Solutions	$165	568%
Security Hlth Comm - All Other Plans	$165	568%
Health Trad Hp - All Plans	$167	575%
Wea Provider Ntwrk - All Plans	$167	575%
Cigna	$169	582%
First Health - All Plans	$169	582%
Geha - All Plans	$169	582%
Group Health Co-Op - All Plans	$169	582%
Health Partners - All Plans	$169	582%
Medical Associates Hp - All Plans	$169	582%
Preferred Health Choice - All Plans	$169	582%
Wps - All Plans	$169	582%

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 $174.
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 Crossing Rivers Health Medical Center 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.