CMS Price Transparency Data

Group therapy session

Facility: Encino Hospital Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $119
  • Cash Discount Price: $130
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Encino Hospital Medical Center is $119. 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 1.15x the Medicare baseline. Located in 16237 Ventura Blvd, Encino, CA.
Cash / Self-Pay
$130

Average discount available for prompt cash payment at this facility.

Insurance Median
$119

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: $119 (115%)
Cash: $130 (125% of Medicare)
Ins. Median: $119 (115% 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
Blue Cross Blue Shield $5 5%
Aids Healthcare Foundation $21 - $133 20%
Blue Shield Of Promise $21 - $130 20%
Health Net Of Ca $21 - $190 20%
La Care Health Plan $21 - $130 20%
Molina $21 - $130 20%
Traditional Medi-Cal $21 20%
Blue Shield Of Ca, Va $26 25%
Aetna $60 - $166 58%
Alignment $60 - $130 58%
Americas Choice Provider Network $60 - $166 58%
Beacon $60 - $239 58%
Brand New Day $60 - $195 58%
Corvel $60 - $163 58%
Employer Direct Healthcare $60 - $182 58%
Healthsmart Preferred Care Network $60 - $168 58%
Imperial Health Plan Ca $60 - $138 58%
Managed Health Network $60 - $130 58%
Medicare (plans) $60 - $130 58%
Multiplan $60 - $166 58%
Prime Health Services, Inc. $60 - $166 58%
Provider Network Of America $60 - $171 58%
Provider Select $60 - $170 58%
Renal Payer Solutions $60 - $130 58%
Three Rivers $60 - $166 58%
Tricare $60 - $130 58%
Usa Senior Care Network $60 - $130 58%
Workers Comp $60 - $171 58%
Zelis Healthcare $60 - $163 58%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16237 Ventura Blvd, Encino, CA 91436
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals