CMS Price Transparency Data

Group therapy session

Facility: Medical West, An Affiliate of UAB Health System

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $43
Cash Discount Price: $38
vs. Medicare Baseline: 0.41x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Medical West, An Affiliate of UAB Health System is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.41x the Medicare baseline. Located in 995 9Th Avenue Southwest, Bessemer, AL.

Cash / Self-Pay

$38

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$103.79

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $103.79 (100%)

Cash / Self-Pay: $38 (37%)

Insurance Median: $43 (41%)

Cash: $38 (37% of Medicare)

Ins. Median: $43 (41% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $103.79 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Cigna	$12 - $97	12%
Viva	$25 - $107	24%
Phcs	$30 - $35	29%
Beech Street	$31 - $35	30%
One Health Plan	$32	31%
Aetna	$35 - $93	34%
Geha	$35	34%
Healthchoice	$35	34%
Alamed	$39	38%
Construction Claims Management	$40	39%
Corvel	$41 - $45	40%
Multiplan	$41	40%
Humana	$42 - $98	40%
Novanet	$42	40%
UnitedHealthcare	$43 - $102	41%
Department Of Labor	$44	42%
Heritage Summit Health	$44	42%
Pnoa	$45	43%
Three Rivers	$45	43%
Blue Cross Blue Shield	$92	89%
Cooper Green	$93	90%
Jefferson County Sheriff	$93	90%
Triwest	$93	90%
United Mine Workers	$93	90%
Ambetter / Centene	$128	123%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $38.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90853.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Medical West, An Affiliate of UAB Health System is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90853.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.