CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Black River Memorial Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $174
  • Cash Discount Price: $193
  • vs. Medicare Baseline: 5.99x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Black River Memorial Hospital is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.99x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.
Cash / Self-Pay
$193

Average discount available for prompt cash payment at this facility.

Insurance Median
$174

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: $193 (664%)
Insurance Median: $174 (599%)
Cash: $193 (664% of Medicare)
Ins. Median: $174 (599% 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 599% of the Medicare baseline (a markup of 499%). 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 $22 - $216 76%
Group Health Cooperative Of Eau Claire $22 - $239 76%
Inclusa $22 76%
My Choice Wisconsin, Inc. $22 - $125 76%
Quartz Health Solutions, Inc $22 - $224 76%
UnitedHealthcare $22 - $232 76%
Humana $93 - $229 320%
Security Health Plan $93 - $230 320%
Corvel $112 - $150 385%
The Alliance $156 - $236 537%
Triology Health Solutions $165 - $234 568%
Medica $171 - $230 588%
Association Benefits Solution $174 - $234 599%
Family Health Center Of Marshfield $174 - $234 599%
First Health Group Corporation $174 - $234 599%
Provider Network Of America $174 - $234 599%
Cigna $178 - $239 613%
Cofinity $178 - $239 613%
Coventry Health Care $178 - $239 613%
Custom Benefit Administrators $178 - $239 613%
Healthpartners, Inc. $178 - $239 613%
Multiplan $178 - $244 613%
Wisconsin Physicians Service Insurance Corp $178 - $239 613%
Chorus $179 - $241 616%

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