CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Rehabilitation Hospital of Wisconsin

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $127
  • Cash Discount Price: $142
  • vs. Medicare Baseline: 4.58x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Rehabilitation Hospital of Wisconsin is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.58x the Medicare baseline. Located in 1625 Coldwater Creek Dr, Waukesha, WI.
Cash / Self-Pay
$142

Average discount available for prompt cash payment at this facility.

Insurance Median
$127

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: $142 (512%)
Insurance Median: $127 (458%)
Cash: $142 (512% of Medicare)
Ins. Median: $127 (458% 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 458% of the Medicare baseline (a markup of 358%). 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
Alliance Ppo $88 - $108 317%
Dean Ppo Hmo/Pos $88 - $108 317%
Medica (Under Dean) $88 - $108 317%
UnitedHealthcare $89 - $157 321%
Trilogy Ppo $91 - $157 328%
Wps "Insurance" Ppo $93 - $115 335%
Phcs Savility $95 - $118 343%
Hps Solutions Ppo $96 - $119 346%
Aetna $99 - $157 357%
Health Eos Poc $102 - $126 368%
Coventry/First Health Ppo $104 - $129 375%
Hps (Other) $104 - $129 375%
Health Eos Multiplan $108 - $134 390%
Phcs / Multiplan $117 - $145 422%
All Savers $127 - $157 458%
Blue Cross Blue Shield $127 - $157 458%
Centivo Broad $127 - $157 458%
Centivo Intermediate/Median $127 - $157 458%
Centivo Narrow/Value $127 - $157 458%
Children'S Communty Health Plan(Cchp) $127 - $157 458%
Cigna $127 - $157 458%
Community Care, Inc $127 - $157 458%
Humana $127 - $157 458%
Icare Mcd $127 - $157 458%
Managed Health Services (Mhs) $127 - $157 458%
Medicaid / KanCare $127 - $157 458%
Medicare (plans) $127 - $157 458%
Molina (Fka Care Wisconsin) $127 - $157 458%
Network Health - Aca $127 - $157 458%
Network Health - Commercial $127 - $157 458%
Quartz (Self Funded) / Unity Health Plan (Hmo/Pos) $127 - $157 458%
Security Health Plan - Advocare $127 - $157 458%
Together With Cchp $127 - $157 458%
Unity Health Plan And Unity Quartz(Hmo/Pos) $127 - $157 458%
Va - Primary Only - Authorization Required $127 - $157 458%
Wellcare Mcr $127 - $157 458%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1625 Coldwater Creek Dr, Waukesha, WI 53188
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL