CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Rehabilitation Hospital of Wisconsin

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $111
  • Cash Discount Price: $134
  • vs. Medicare Baseline: 3.39x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Rehabilitation Hospital of Wisconsin is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 3.39x the Medicare baseline. Located in 1625 Coldwater Creek Dr, Waukesha, WI.
Cash / Self-Pay
$134

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
$32.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.73 (100%)
Cash / Self-Pay: $134 (409%)
Insurance Median: $111 (339%)
Cash: $134 (409% of Medicare)
Ins. Median: $111 (339% 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 339% of the Medicare baseline (a markup of 239%). 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 $76 - $108 232%
Dean Ppo Hmo/Pos $76 - $108 232%
Medica (Under Dean) $76 - $108 232%
UnitedHealthcare $77 - $157 235%
Trilogy Ppo $80 - $157 244%
Wps "Insurance" Ppo $81 - $115 247%
Phcs Savility $83 - $118 254%
Hps Solutions Ppo $84 - $119 257%
Aetna $86 - $157 263%
Health Eos Poc $89 - $126 272%
Coventry/First Health Ppo $91 - $129 278%
Hps (Other) $91 - $129 278%
Health Eos Multiplan $94 - $134 287%
Phcs / Multiplan $102 - $145 312%
All Savers $111 - $157 339%
Blue Cross Blue Shield $111 - $157 339%
Centivo Broad $111 - $157 339%
Centivo Intermediate/Median $111 - $157 339%
Centivo Narrow/Value $111 - $157 339%
Children'S Communty Health Plan(Cchp) $111 - $157 339%
Cigna $111 - $157 339%
Community Care, Inc $111 - $157 339%
Humana $111 - $157 339%
Icare Mcd $111 - $157 339%
Managed Health Services (Mhs) $111 - $157 339%
Medicaid / KanCare $111 - $157 339%
Medicare (plans) $111 - $157 339%
Molina (Fka Care Wisconsin) $111 - $157 339%
Network Health - Aca $111 - $157 339%
Network Health - Commercial $111 - $157 339%
Quartz (Self Funded) / Unity Health Plan (Hmo/Pos) $111 - $157 339%
Security Health Plan - Advocare $111 - $157 339%
Together With Cchp $111 - $157 339%
Unity Health Plan And Unity Quartz(Hmo/Pos) $111 - $157 339%
Va - Primary Only - Authorization Required $111 - $157 339%
Wellcare Mcr $111 - $157 339%

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