CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Childrens Hospital of Wisconsin

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $135
  • Cash Discount Price: $93
  • vs. Medicare Baseline: 4.65x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Childrens Hospital of Wisconsin is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.65x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$93

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $93 (320%)
Insurance Median: $135 (465%)
Cash: $93 (320% of Medicare)
Ins. Median: $135 (465% 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 465% of the Medicare baseline (a markup of 365%). 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
My Choice Wisconsin $31 - $35 107%
UnitedHealthcare $31 - $129 107%
Chorus Community Health Plan $32 110%
Managed Health Services $34 117%
Molina Healthcare Of Wisconsin $35 120%
Blue Cross Blue Shield $36 - $161 124%
Icare $39 134%
Froedtert Health $118 - $144 406%
Medical College Of Wisconsin $118 406%
Network Health Plan $121 416%
Aspirus Health Plan $127 437%
Common Ground Healthcare Cooperative $127 - $144 437%
Trilogy Health Solutions $127 - $144 437%
Wps Health Plan $129 - $152 444%
Advocate Aurora Healthcare $130 447%
Centivo $132 454%
Health Partners $132 - $149 454%
Employer Health Care Alliance Cooperative $133 458%
Dean Health Plan $135 465%
Group Health Cooperative Of Eau Claire $135 465%
Oan Llc $135 465%
Security Health Plan $140 482%
Health Payment Systems $143 492%
Praire States $144 496%
Quartz Health Insurance $144 496%
Sheboygan Employer'S Health Network $144 496%
Mayo Clinic Health Solutions $147 506%
Aetna $149 - $151 513%
Bellin Thedacare $152 523%
Cigna $152 523%
Group Health Cooperative Of South Central Wisconsin $152 523%
Prevea Health Network $152 523%
Multiplan $154 - $161 530%
Coventry Health Care $161 554%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens