CMS Price Transparency Data

Group therapy session

Facility: Adventist Health Reedley

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $26
  • Cash Discount Price: $14
  • vs. Medicare Baseline: 0.25x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Adventist Health Reedley is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.25x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.
Cash / Self-Pay
$14

Average discount available for prompt cash payment at this facility.

Insurance Median
$26

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: $14 (13%)
Insurance Median: $26 (25%)
Cash: $14 (13% of Medicare)
Ins. Median: $26 (25% 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
Bc Mcal $3 3%
Cal Viva Hlth Mcal - All Plans $3 3%
Central Ca Alliance Mcal Profee Only $3 3%
Dignity Mcal Op/Profee Only-All Other Plans $3 3%
Medi-Cal $3 3%
Upn Mcal Profee Only-All Other Plans $3 3%
Kern Health Systems Mcal-All Plans $4 4%
Central Ca Alliance Ccs Profee Only $5 5%
Central Ca Alliance Comm Profee Only - All Other P $5 5%
Central Ca Alliance Chdp Profee Only $7 7%
Blue Shield Mcare $25 24%
Fhcn Pace Mcr Adv-All Plans $25 24%
Lasalle Med Assoc Profee Only - All Plans $25 24%
Tricare $25 24%
UnitedHealthcare $25 - $32 24%
Upn Mcr Adv Profee Only $25 24%
Ah Employee Health Plan - All Plans $27 26%
Cigna $29 28%
Community Care Ipa Mcal-All Plans $30 29%
Kaiser - All Other Plans $33 32%
Kaiser Mcr Adv $33 32%
Western Growers/Pinnacle- All Plans $34 33%
Healthnet- All Other Plans $36 35%
Aetna $41 40%
Physicians Med Group Op/Profee Only- All Plans $58 56%
Blue Cross Blue Shield $63 61%
Blue Shield Epn - All Other Plans $64 62%
Blue Shield Non Epn $68 66%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 372 W Cypress Ave, Reedley, CA 93654
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals