CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Rehabilitation Hospital of Wisconsin

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $155
  • Cash Discount Price: $157
  • vs. Medicare Baseline: 5.33x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Rehabilitation Hospital of Wisconsin is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $157. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.33x the Medicare baseline. Located in 1625 Coldwater Creek Dr, Waukesha, WI.
Cash / Self-Pay
$157

Average discount available for prompt cash payment at this facility.

Insurance Median
$155

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: $157 (540%)
Insurance Median: $155 (533%)
Cash: $157 (540% of Medicare)
Ins. Median: $155 (533% 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 533% of the Medicare baseline (a markup of 433%). 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 $107 - $108 368%
Dean Ppo Hmo/Pos $107 - $108 368%
Medica (Under Dean) $107 - $108 368%
UnitedHealthcare $109 - $157 375%
Trilogy Ppo $112 - $157 385%
Wps "Insurance" Ppo $113 - $115 389%
Phcs Savility $116 - $118 399%
Hps Solutions Ppo $118 - $119 406%
Aetna $121 - $157 416%
Health Eos Poc $124 - $126 427%
Coventry/First Health Ppo $127 - $129 437%
Hps (Other) $127 - $129 437%
Health Eos Multiplan $132 - $134 454%
Phcs / Multiplan $143 - $145 492%
All Savers $155 - $157 533%
Blue Cross Blue Shield $155 - $157 533%
Centivo Broad $155 - $157 533%
Centivo Intermediate/Median $155 - $157 533%
Centivo Narrow/Value $155 - $157 533%
Children'S Communty Health Plan(Cchp) $155 - $157 533%
Cigna $155 - $157 533%
Community Care, Inc $155 - $157 533%
Humana $155 - $157 533%
Icare Mcd $155 - $157 533%
Managed Health Services (Mhs) $155 - $157 533%
Medicaid / KanCare $155 - $157 533%
Medicare (plans) $155 - $157 533%
Molina (Fka Care Wisconsin) $155 - $157 533%
Network Health - Aca $155 - $157 533%
Network Health - Commercial $155 - $157 533%
Quartz (Self Funded) / Unity Health Plan (Hmo/Pos) $155 - $157 533%
Security Health Plan - Advocare $155 - $157 533%
Together With Cchp $155 - $157 533%
Unity Health Plan And Unity Quartz(Hmo/Pos) $155 - $157 533%
Va - Primary Only - Authorization Required $155 - $157 533%
Wellcare Mcr $155 - $157 533%

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