CMS Price Transparency Data

Group therapy session

Facility: El Dorado Springs

Billing Code: 90853 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$79

about 0.8× the $104 Medicare rate · typically $25–$196

modeled estimate · not a bill or quote

Medicare pays $104 Fair price $79 Cash price $282 Hospital's list price $292

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana UnitedHealthcareKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Blue Cross Blue Shieldmajor	$160 - $296	154%
Aetnamajor	$235	226%
Cignamajor	$260	251%
Humanamajor	$296 - $350	285%
Health Net	$350 - $530	337%
+ 11 smaller / regional plans	$160 - $710

Government programs also on file: Military & VA.

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 282), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90853.

Insurance Before you use insurance

Call your insurance company to confirm El Dorado Springs is in-network.
Ask your insurer whether prior approval is required for CPT code 90853.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Compare: Group therapy session at other AZ hospitals

Insurance negotiated median for the same procedure, sorted lowest first.