CMS Price Transparency Data

Group therapy session

Facility: Banner Payson Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $194
  • Cash Discount Price: $151
  • vs. Medicare Baseline: 1.87x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Banner Payson Medical Center is $194. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.87x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$151

Average discount available for prompt cash payment at this facility.

Insurance Median
$194

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: $151 (145%)
Insurance Median: $194 (187%)
Cash: $151 (145% of Medicare)
Ins. Median: $194 (187% 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
Arizona Physicians Ipa $54 - $194 52%
Banner University Health Plan $54 - $194 52%
Health Choice Arizona, Inc. $54 - $277 52%
Health Net $54 - $287 52%
Mercy Care $54 - $194 52%
Aetna $91 - $313 88%
Banner Health $91 - $194 88%
Blue Cross Blue Shield $91 - $244 88%
Care 1St $91 - $194 88%
Cigna $91 - $377 88%
Gila River Health Care Corporation $91 - $194 88%
Kaiser Foundation Health Plan $91 - $194 88%
Triwest Healthcare Alliance Corp - Va Ccn $91 - $194 88%
Upmc Health Plan $91 - $194 88%
Wellpoint $91 - $194 88%
Carelon $96 - $204 92%
Humana $96 - $206 92%
Arizona Priority Care $100 - $213 96%
Devoted Health Services $100 - $213 96%
Gold Kidney Health Plan $100 - $213 96%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $100 - $213 96%
Plotkin Health $100 - $213 96%
Oscar Health Plan $150 - $320 145%
Quiktrip Corporation $155 - $331 149%
Arizona Medical Network $200 - $426 193%
Provider Network Of America $200 - $426 193%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 807 South Ponderosa Drive, Payson, AZ 85541
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals