CMS Price Transparency Data

Group therapy session

Facility: Oro Valley Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $112
  • Cash Discount Price: $124
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Oro Valley Hospital is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $124. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.08x the Medicare baseline. Located in 1551 East Tangerine Road, Oro Valley, AZ.
Cash / Self-Pay
$124

Average discount available for prompt cash payment at this facility.

Insurance Median
$112

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: $124 (119%)
Insurance Median: $112 (108%)
Cash: $124 (119% of Medicare)
Ins. Median: $112 (108% 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%
Magellan $56 - $226 54%
Blue Cross Blue Shield $58 - $196 56%
Aetna $71 - $126 68%
Self Pay $90 - $158 87%
Caremore Health Plan $107 103%
Cigna $107 - $113 103%
Humana $107 - $325 103%
Medicare (plans) $107 103%
Pascua Yaqui Tribe $107 103%
Scan Health $107 103%
Department Of Veterans Affairs $108 104%
Node Non Par Hospice Agree $108 104%
Node Triwest $108 104%
Node Va $108 104%
Tricare $108 104%
Clover Health Mcr Adv $109 105%
Fresenius Health $109 105%
Node Devoted Health Mcr Adv $110 106%
Node Banner Mcr Adv $112 108%
Wellcare Mcr Adv $112 108%
Node Us Dept Of Labor $136 131%
Ambetter / Centene $153 147%
Node Health Choice Exchange $162 156%
Beacon Health Options $188 181%
Mtc $188 181%
Node Fusion Network $195 188%
First Health Coventry $197 190%
Node J Allen Inmate Health Svcs $206 198%
Coventry Work Comp Al $226 218%
Health Net $228 220%
Seven Corners $249 240%
Multiplan $312 301%
Prime Health $320 308%
Three Rivers $320 308%
Healthsmart $338 326%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1551 East Tangerine Road, Oro Valley, AZ 85755
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals