CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Bellin Health Oconto Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $79
Cash Discount Price: $67
vs. Medicare Baseline: 2.72x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Bellin Health Oconto Hospital is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.72x the Medicare baseline. Located in 820 Arbutus Ave, Oconto, WI.

Cash / Self-Pay

$67

Average discount available for prompt cash payment at this facility.

Insurance Median

$79

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: $67 (231%)

Insurance Median: $79 (272%)

Cash: $67 (231% of Medicare)

Ins. Median: $79 (272% 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 272% of the Medicare baseline (a markup of 172%). 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	$35 - $220	120%
Community Care	$35	120%
Humana	$35	120%
My Choice	$35	120%
Network Health	$35 - $88	120%
UnitedHealthcare	$42 - $72	145%
Aetna	$52	179%
Cigna	$73 - $74	251%
Common Ground	$75 - $77	258%
Chorus Community Health Plan	$77	265%
Aspirus Arise	$81	279%
Healthsmart	$82	282%
Ihs(Claimsbridge)	$82	282%
Medical College Of Wi	$82	282%
Hps/Paymedix	$84 - $92	289%
Wps Insurance	$86	296%
Allied National	$88	303%
First Health	$88	303%
Galaxy Health	$88	303%
Three Rivers Provider Network	$93	320%
Trilogy	$93	320%

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 $67.
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 Bellin Health Oconto Hospital 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.