CMS Price Transparency Data
Group therapy session
Facility: Mercy Hospital Berryville
Billing Code: 90853 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90853
- Insurance Median: $253
- Cash Discount Price: $424
- vs. Medicare Baseline: 2.44x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Mercy Hospital Berryville is $253. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $424. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.44x the Medicare baseline. Located in 214 Carter Street, Berryville, AR.
Cash / Self-Pay
$424
Average discount available for prompt cash payment at this facility.
Insurance Median
$253
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: $424 (409%)
Insurance Median: $253 (244%)
Cash: $424 (409% of Medicare)
Ins. Median: $253 (244% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 244% of the Medicare baseline (a markup of 144%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $25 - $343 | 24% |
| Blue Cross Blue Shield | $79 - $226 | 76% |
| UnitedHealthcare | $79 - $530 | 76% |
| Qual Choice Contracted [320324] | $80 | 77% |
| Aetna | $108 - $226 | 104% |
| American Health Advantage Of Mo Mcr [20264] | $108 - $226 | 104% |
| Cherokee Nation Health Serv Contracted [320066] | $108 - $226 | 104% |
| Cross Timbers Hospice [20098] | $108 - $226 | 104% |
| Dept Of Veteran Affairs Contracted [320106] | $108 - $226 | 104% |
| Elara Caring Aspire Hospice [20433] | $108 - $226 | 104% |
| Globalhealth Contracted [320145] | $108 - $226 | 104% |
| Halo Hcr Inc Hospice Contracted [320432] | $108 - $226 | 104% |
| Halo Hcr Inc Hospice [20432] | $108 - $226 | 104% |
| Humana | $108 - $751 | 104% |
| Independent Health [20197] | $108 - $226 | 104% |
| Indian Health Service Contracted [320198] | $108 - $226 | 104% |
| Indian Health Service [20198] | $108 - $226 | 104% |
| Jordan Valley Senior Care Pace [20515] | $108 - $226 | 104% |
| Kindful Hospice Contracted [320434] | $108 - $226 | 104% |
| Kindful Hospice [20434] | $108 - $226 | 104% |
| Medical Associates Health [20444] | $108 - $226 | 104% |
| Medicare (plans) | $108 - $237 | 104% |
| Mercy Hospice Okc [20252] | $108 - $226 | 104% |
| Mercy Mgd Behavioral Health Contracted [320259] | $108 - $226 | 104% |
| Pace Of The Ozarks [20518] | $108 - $226 | 104% |
| Provider Partners Health Plans Contracted [320450] | $108 - $226 | 104% |
| Qual Choice Contracted [320325] | $108 - $226 | 104% |
| Spina Bifida Hlthcare Benefit [20506] | $108 - $226 | 104% |
| Valir Pace [20503] | $108 - $226 | 104% |
| Wellfirst Health Mcr [20443] | $108 - $226 | 104% |
| Tricare | $110 - $230 | 106% |
| Cigna | $113 - $237 | 109% |
| Mercy Interfacility [20513] | $123 - $258 | 119% |
| Healthscope Contracted [320182] | $135 - $282 | 130% |
| Ambetter / Centene | $164 - $343 | 158% |
| Home State Health Plan Contracted [320187] | $164 - $343 | 158% |
| Novasys Contracted [320285] | $171 - $358 | 165% |
| Administrative Payor Contracted [320005] | $190 - $398 | 183% |
| Auxiant Contracted [320462] | $253 - $796 | 244% |
| United Medical Resources Contracted [320454] | $253 - $751 | 244% |
| Healthlink Contracted [320179] | $274 - $751 | 264% |
| Mercy Benefit Admin Contracted [320251] | $274 - $751 | 264% |
| Personify Health Contracted [320051] | $274 - $575 | 264% |
| Preferred Health Plan Contracted [320522] | $274 - $575 | 264% |
| Insurance System Inc Contracted [320465] | $338 - $707 | 326% |
| Point C Contracted [320238] | $338 - $707 | 326% |
| Medica Contracted [320239] | $357 - $748 | 344% |
| 90 Degree Benefits Contracted [320436] | $359 - $751 | 346% |
| Aither Health Contracted [320449] | $359 - $751 | 346% |
| Benefit Management Contracted [320052] | $359 - $751 | 346% |
| Ebms Contracted [320493] | $359 - $751 | 346% |
| Edison Health Solutions Contracted [320502] | $359 - $751 | 346% |
| First Health Contracted [320128] | $359 - $751 | 346% |
| Healthsmart Preferred Care Contracted [320184] | $359 - $751 | 346% |
| Imagine 360 Contracted [320494] | $359 - $751 | 346% |
| Ppo Plus Contracted [320310] | $359 - $751 | 346% |
| Reflect Health Contracted [320492] | $359 - $751 | 346% |
| Show-Me Health Administrators Contracted [320483] | $359 - $751 | 346% |
| Multiplan Contracted [320270] | $401 - $840 | 386% |
| Private Health Care Systems Contracted [320320] | $401 - $840 | 386% |