CMS Price Transparency Data
Group therapy session
Facility: Adventist Health White Memorial
Billing Code: 90853 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90853
- Insurance Median: $131
- Cash Discount Price: $80
- vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Adventist Health White Memorial is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.26x the Medicare baseline. Located in 1720 Cesar E Chavez Avenue, Los Angeles, CA.
Cash / Self-Pay
$80
Average discount available for prompt cash payment at this facility.
Insurance Median
$131
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: $80 (77%)
Insurance Median: $131 (126%)
Cash: $80 (77% of Medicare)
Ins. Median: $131 (126% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bc Medi-Cal | $6 | 6% |
| Access Medi-Cal | $24 | 23% |
| Ahp Medi-Cal | $24 | 23% |
| Alta Los Angeles Mcal 1/1/19 | $24 | 23% |
| Avanti Mcal | $24 | 23% |
| Bella Vista Medi-Cal Op/Profee Only | $24 | 23% |
| Healthcare Inc Medi-Cal | $24 | 23% |
| Lasalle Mg Medi-Cal | $24 | 23% |
| Medi-Cal | $24 | 23% |
| Molina Medi-Cal | $24 | 23% |
| Pacific Alliance Medi-Cal | $24 | 23% |
| Pacific Ipa Medi-Cal | $24 | 23% |
| Preferred Ipa La Care Mcal Cap | $24 | 23% |
| Preferred Medi-Cal | $24 | 23% |
| Altamed Medi-Cal - All Other Plans | $28 | 27% |
| Fcs Ipa Medi-Cal Op/Profee Only | $29 | 28% |
| Healthnet Mcal | $29 | 28% |
| Preferred Healthy | $30 | 29% |
| Assoc Hispanic Physcns Mcal | $34 | 33% |
| Blue Shield Medi-Cal | $60 | 58% |
| Care First Medi-Cal | $84 | 81% |
| Blue Shield Epn | $106 | 102% |
| Access Group | $111 | 107% |
| Ahp - All Other Plans | $111 | 107% |
| Lasalle Mg Commercial - All Other Plans | $111 | 107% |
| Blue Shield - All Other Plans | $124 | 119% |
| Access Senior - All Other Plans | $131 | 126% |
| Ahp Senior | $131 | 126% |
| Alta Los Angeles Mcr 1/1/19-All Other Plans | $131 | 126% |
| Altamed Connect | $131 | 126% |
| Avanti Mcr Adv - All Other Plans | $131 | 126% |
| Brand New Day Mcare - All Plans | $131 | 126% |
| Bs Va Mcare | $131 | 126% |
| Care First Mcare - All Other Plans | $131 | 126% |
| Clever Care - All Plans | $131 | 126% |
| Fcs Ipa Mcr Advan Op/Profee Only | $131 | 126% |
| Humana | $131 | 126% |
| Lasalle Mg Senior | $131 | 126% |
| Medicare (plans) | $131 | 126% |
| Molina Mcare | $131 | 126% |
| Pacific Alliance Mcare - All Other Plans | $131 | 126% |
| Preferred Senior | $131 | 126% |
| Sunlight Living Hlth Mcr Adv-All Other Plans | $131 | 126% |
| Tricare | $131 | 126% |
| Blue Shield Mcr Adv | $134 | 129% |
| Blue Cross Blue Shield | $136 - $201 | 131% |
| Fcs Ipa Op/Profee Only - All Other Plans | $137 | 132% |
| Bright Health - All Plans | $150 | 145% |
| Assoc Hispanic Physcns Hmo/Mcr Adv-All Other Plans | $157 | 151% |
| Preferred Commercial - All Other Plans | $157 | 151% |
| Intergrated Medical - All Plans | $170 | 164% |
| Pacific Ipa - All Other Plans | $170 | 164% |
| Molina Benefit Exchange - All Other Plans | $176 | 170% |
| Kaiser- All Plans | $183 | 176% |
| Cigna | $189 | 182% |
| Php-Prospect Health Plan Cap - All Plans | $196 | 189% |
| Healthnet - All Other Plans | $202 | 195% |
| Healthnet Comm Care | $209 | 201% |
| UnitedHealthcare | $215 | 207% |
| Aetna | $217 | 209% |
| Caremore Mcare - All Plans | $224 | 216% |
| Hcpamg - All Plans | $224 | 216% |
| Ah Employee Health Plan - All Plans | $235 | 226% |
| Healthcare Inc - All Other Plans | $246 | 237% |
| La Care Mcr Adv - All Plans | $246 | 237% |
| Western Growers/Pinnacle - All Plans | $250 | 241% |
| First Heatlh Ppo - All Plans | $259 | 250% |
| Phcs Ppo - All Plans | $291 | 280% |
| Scan Health Mcare - All Plans | $291 | 280% |
| Centivo - All Plans | $294 | 283% |
| Ahf - All Plans | $335 | 323% |
| Beech Street - All Plans | $335 | 323% |
| Interplan Ppo - All Plans | $335 | 323% |
| Corvel Corp - All Plans | $358 | 345% |
| Multiplan Ppo - All Plans | $371 | 357% |
| Healthmannet - All Plans | $380 | 366% |
| Next Inc Ppo - All Plans | $380 | 366% |
| Trpn - All Plans | $380 | 366% |
| Bella Vista Mcr Adv Op/Profee Only - All Other Pla | $402 | 387% |
| Fpn Ppo - All Plans | $402 | 387% |
| Healthnet Mcr Adv | $684 | 659% |