CMS Price Transparency Data

Group therapy session

Facility: Northwest Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $109
  • Cash Discount Price: $113
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Northwest Medical Center is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.05x the Medicare baseline. Located in 6200 North La Cholla Boulevard, Tucson, AZ.
Cash / Self-Pay
$113

Average discount available for prompt cash payment at this facility.

Insurance Median
$109

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: $113 (109%)
Insurance Median: $109 (105%)
Cash: $113 (109% of Medicare)
Ins. Median: $109 (105% 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.

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
Veterans Eval Services $28 27%
Medicaid / KanCare $54 - $58 52%
Blue Cross Blue Shield $56 - $196 54%
Magellan $56 - $112 54%
Aetna $68 - $169 66%
Self Pay $90 - $135 87%
Cigna $107 - $113 103%
Humana $107 103%
Medicare (plans) $107 103%
Node Caremore Mcr Adv $107 103%
Pascua Yaqui Tribe $107 103%
Scan Health Plan $107 103%
Department Of Veterans Affairs $108 104%
Node Non Par Hospice Agree $108 104%
Node Va $108 104%
Tricare $108 104%
Triwest $108 104%
Fresenius Health $109 105%
Node Clover Health Mcr Adv $109 105%
Node Devoted Health Mcr Adv $110 106%
Node Banner Mcr Adv $112 108%
Wellcare $112 108%
Node Us Dept Of Labor $136 131%
Ambetter / Centene $153 147%
Node Health Choice Health Exchange $159 153%
Health Net $172 166%
UnitedHealthcare $188 181%
Node Fusion Network $195 188%
First Health Coventry $197 190%
Node J Allen Inmate Health Svcs $206 198%
Coventry Medical Center $226 218%
Seven Corners $249 240%
Multiplan $312 301%
Prime Health $320 308%
Healthsmart $338 326%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6200 North La Cholla Boulevard, Tucson, AZ 85741
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals