CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Black River Memorial Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $153
Cash Discount Price: $151
vs. Medicare Baseline: 4.67x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Black River Memorial Hospital is $153. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 4.67x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$153

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$32.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.73 (100%)

Cash / Self-Pay: $151 (461%)

Insurance Median: $153 (467%)

Cash: $151 (461% of Medicare)

Ins. Median: $153 (467% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $32.73 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 467% of the Medicare baseline (a markup of 367%). 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	$22 - $148	67%
Group Health Cooperative Of Eau Claire	$22 - $163	67%
Inclusa	$22	67%
My Choice Wisconsin, Inc.	$22 - $86	67%
Quartz Health Solutions, Inc	$22 - $153	67%
UnitedHealthcare	$22 - $158	67%
Humana	$86 - $156	263%
Security Health Plan	$86 - $157	263%
Corvel	$102	312%
The Alliance	$143 - $161	437%
Triology Health Solutions	$151 - $160	461%
Medica	$157	480%
Association Benefits Solution	$160	489%
Family Health Center Of Marshfield	$160	489%
First Health Group Corporation	$160	489%
Provider Network Of America	$160	489%
Cigna	$163	498%
Cofinity	$163	498%
Coventry Health Care	$163	498%
Custom Benefit Administrators	$163	498%
Healthpartners, Inc.	$163	498%
Multiplan	$163 - $166	498%
Wisconsin Physicians Service Insurance Corp	$163	498%
Chorus	$165	504%

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 $151.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97112.

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 97112.
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.