CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Black River Memorial Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $111
Cash Discount Price: $120
vs. Medicare Baseline: 4.00x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Black River Memorial Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.00x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$120

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $120 (433%)

Insurance Median: $111 (400%)

Cash: $120 (433% of Medicare)

Ins. Median: $111 (400% 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 400% of the Medicare baseline (a markup of 300%). 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	$27 - $150	97%
Group Health Cooperative Of Eau Claire	$27 - $165	97%
Inclusa	$27	97%
My Choice Wisconsin, Inc.	$27 - $87	97%
Quartz Health Solutions, Inc	$27 - $155	97%
UnitedHealthcare	$27 - $160	97%
Humana	$58 - $158	209%
Security Health Plan	$58 - $159	209%
Corvel	$70 - $104	253%
The Alliance	$97 - $163	350%
Triology Health Solutions	$103 - $162	372%
Medica	$106 - $159	382%
Association Benefits Solution	$108 - $162	390%
Family Health Center Of Marshfield	$108 - $162	390%
First Health Group Corporation	$108 - $162	390%
Provider Network Of America	$108 - $162	390%
Cigna	$111 - $165	400%
Cofinity	$111 - $165	400%
Coventry Health Care	$111 - $165	400%
Custom Benefit Administrators	$111 - $165	400%
Healthpartners, Inc.	$111 - $165	400%
Multiplan	$111 - $168	400%
Wisconsin Physicians Service Insurance Corp	$111 - $165	400%
Chorus	$112 - $167	404%

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 $120.
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 Black River Memorial 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.