Occupational therapy (self-care training) cost in WI
What a occupational therapy (self-care training) costs at WI hospitals — and the fair price to aim for.
Typical commercial prices here are +16% above the fair benchmark (1.16×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Wide Procedure Spread · Upper-Quartile Skew Pricer
This hospital prices routine shoppable procedures at 2.0× Medicare (median 1.05× Fair BaseRate) while upper-quartile commercial rates jump +74% to 1.83× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.92× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 98% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (78.4% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 2.5× markup over Medicare rates
- Commercial insurance median sits at 1.05× Fair BaseRate (2.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.83×) jump +74% above the median procedure ratio (Q50 1.05×)
- Consolidated metro market (HHI 3,939) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
In general, WI hospitals charge below the fair price — a good state to get this done. how we calculate the BaseRate →
Compared with the rest of the country, WI’s fair BaseRate ($49) is above the national fair price of $41.
Cheapest WI hospitals for a occupational therapy (self-care training)
- Childrens Hospital of Wisconsin Fox Valley · Neenah $23
- Childrens Hospital of Wisconsin · Milwaukee $23
- SSM Health St Mary's Hospital - Madison · Madison $28
- SSM Health St Clare Hospital - Baraboo · Baraboo $28
- Thedacare Regional Medical Center - Appleton Inc · Appleton $30
- Thedacare Medical Center - Shawano · Shawano $31
- St Josephs Community Hospital West Bend · West Bend $31
- Froedtert Memorial Lutheran Hospital · Milwaukee $31
- Froedtert Community Hospital · New Berlin $31
- Sauk Prairie Hospital · Prairie Du Sac $31
- Community Memorial Hospital · Menomonee Falls $31
- Holy Family Memorial · Manitowoc $31
- Oakleaf Surgical Hospital · Altoona $31
- Gundersen Lutheran Medical Center · La Crosse $31
- Bellin Memorial Hospital · Green Bay $31
Audit a Bill or Quote at WI Hospital Benchmark (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $38
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $38).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask WI Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $49 Fair BaseRate ($28 Medicare)
Your bill ($106) is $57 above the denoised Fair BaseRate ($49) and 3.8× the $28 Medicare rate.