CMS Price Transparency Data

Group therapy session

Facility: Sharp Chula Vista Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $278
Cash Discount Price: $343
vs. Medicare Baseline: 2.68x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Sharp Chula Vista Medical Center is $278. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $343. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.68x the Medicare baseline. Located in 751 Medical Center Court, Chula Vista, CA.

Cash / Self-Pay

$343

Average discount available for prompt cash payment at this facility.

Insurance Median

$278

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: $343 (330%)

Insurance Median: $278 (268%)

Cash: $343 (330% of Medicare)

Ins. Median: $278 (268% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 268% of the Medicare baseline (a markup of 168%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$29 - $376	28%
Health Net	$29 - $446	28%
Molina	$29 - $410	28%
San Diego Pace	$29 - $450	28%
Aetna	$39 - $386	38%
Blue Shield	$64 - $446	62%
Cigna	$64 - $373	62%
Managed Health Network	$64 - $344	62%
Community Health Group	$68 - $1,106	66%
Medicare (plans)	$95 - $318	92%
UnitedHealthcare	$127 - $364	122%
Interplan	$135 - $308	130%
Indian Health Council	$136 - $1,256	131%
Medi-Cal	$136 - $410	131%
Epic Americas	$155 - $321	149%
County Medical Services	$156 - $410	150%
California Health And Wellness	$179 - $1,106	172%
Kaiser	$218 - $373	210%
Multiplan	$259 - $364	250%
Allianz Global Assistance	$282 - $364	272%
Humana	$298 - $413	287%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $343.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90853.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sharp Chula Vista Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90853.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.