CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Black River Memorial Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $119
  • Cash Discount Price: $125
  • vs. Medicare Baseline: 3.53x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Black River Memorial Hospital is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.53x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.
Cash / Self-Pay
$125

Average discount available for prompt cash payment at this facility.

Insurance Median
$119

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$33.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $33.73 (100%)
Cash / Self-Pay: $125 (371%)
Insurance Median: $119 (353%)
Cash: $125 (371% of Medicare)
Ins. Median: $119 (353% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $33.73 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 353% of the Medicare baseline (a markup of 253%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $63 - $136 187%
Humana $63 - $144 187%
My Choice Wisconsin, Inc. $63 - $79 187%
Quartz Health Solutions, Inc $63 - $141 187%
Security Health Plan $63 - $145 187%
UnitedHealthcare $63 - $146 187%
Corvel $75 - $95 222%
The Alliance $105 - $149 311%
Triology Health Solutions $111 - $147 329%
Medica $115 - $145 341%
Association Benefits Solution $117 - $147 347%
Family Health Center Of Marshfield $117 - $147 347%
First Health Group Corporation $117 - $147 347%
Provider Network Of America $117 - $147 347%
Cigna $119 - $150 353%
Cofinity $119 - $150 353%
Coventry Health Care $119 - $150 353%
Custom Benefit Administrators $119 - $150 353%
Group Health Cooperative Of Eau Claire $119 - $150 353%
Healthpartners, Inc. $119 - $150 353%
Multiplan $119 - $153 353%
Wisconsin Physicians Service Insurance Corp $119 - $150 353%
Chorus $121 - $152 359%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 711 W Adams St, Black River Falls, WI 54615
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals