CMS Price Transparency Data

Group therapy session

Facility: Phoenix Children's Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $86
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.83x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Phoenix Children's Hospital is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.83x the Medicare baseline. Located in 1919 East Thomas Road, Phoenix, AZ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$86

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%)
Insurance Median: $86 (83%)
Ins. Median: $86 (83% 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
Ahccs $4 - $99 4%
Ahc Apipa $6 6%
Ahc Cmdp $6 6%
Ahc Crs $6 - $99 6%
Ahc Ihs $6 6%
Ahc Mercy Care $6 6%
Ahc University $7 7%
Ahc Healthchoice $52 50%
Ahc Lcd $54 52%
Healthcomp $81 78%
Intel $81 78%
Cigna $84 - $162 81%
UnitedHealthcare $88 - $96 85%
Aetna $93 - $148 90%
Ahc Care First $99 95%
Antidote $131 126%
Multiplan $162 156%
Blue Cross Blue Shield $202 195%
Selfpay $219 211%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1919 East Thomas Road, Phoenix, AZ 85016
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens