CMS Price Transparency Data

Group therapy session

Facility: Paradise Valley Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $130
  • Cash Discount Price: $130
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Paradise Valley Hospital is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.25x the Medicare baseline. Located in 2400 East 4Th St, National City, CA.
Cash / Self-Pay
$130

Average discount available for prompt cash payment at this facility.

Insurance Median
$130

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: $130 (125%)
Insurance Median: $130 (125%)
Cash: $130 (125% of Medicare)
Ins. Median: $130 (125% 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
Aetna $21 - $166 20%
Blue Sheid Of Promise $21 20%
County Of San Diego $21 20%
Golden Physicians Medical Group $21 - $163 20%
Health Excel Ins $21 - $130 20%
Heritage Provider Netwrok $21 - $169 20%
Molina $21 - $130 20%
Traditional Medi-Cal $21 20%
UnitedHealthcare $21 - $130 20%
Health Net Of Ca $22 - $190 21%
Blue Shield Of Ca, Va $25 24%
Community Health Group $25 - $130 24%
Ca Foundation For Medical Care $130 125%
Central Health $130 125%
Choice Physicians Network $130 125%
Clever Care Of Golden State, Inc $130 125%
Managed Health Network $130 125%
Medicare (plans) $130 125%
Renal Payer Solutions $130 125%
Tricare $130 125%
Usa Senior Care Network $130 125%
Verda Health Plan $130 125%
Brand New Day $131 - $195 126%
Imperial Health Plan Of Ca $138 133%
Health Net Federal Service (Cdcr) $163 157%
Veterans Evaluation Services $163 157%
Worker Comp $171 165%
Integrated Medical Solutions $172 166%
Ca Dept Of Correction & Rehab $182 175%
Employer Direct Healthcare $182 175%
Naphcare $202 - $260 195%
Scripps Health $221 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 East 4Th St, National City, CA 91950
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals