Group therapy session
Facility: Glendale Adventist Medical Center
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $315
- Cash Discount Price: $88
- vs. Medicare Baseline: 3.03x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 303% of the Medicare baseline (a markup of 203%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 | $7 | 7% |
| Medi-Cal | $24 | 23% |
| Molina Mcal | $24 | 23% |
| Heritage Mcal | $25 | 24% |
| Healthnet Mcal | $29 | 28% |
| Blue Shield Medi-Cal | $60 | 58% |
| Blue Shield Mcr Adv | $131 | 126% |
| Clever Care Mcr Adv - All Plans | $131 | 126% |
| Molina Mcr | $131 | 126% |
| Regal Med Group Mcal | $131 | 126% |
| Tricare | $131 | 126% |
| Blue Cross Blue Shield | $136 - $702 | 131% |
| Regal Medical Group Commercial - All Other Plans | $157 | 151% |
| Dept Of State Hsp Metropolitan- All Plans | $170 | 164% |
| Employers Health Network - All Plans | $175 | 169% |
| Phys Assoc Op Only- All Plans | $175 | 169% |
| Molina Exchange - All Other Plans | $176 | 170% |
| Blue Shield Epn - All Other Plans | $215 | 207% |
| La Care Mcr Adv- All Plans | $220 - $350 | 212% |
| Caremore Mcr Adv - All Plans | $227 - $488 | 219% |
| Ah Employee Health Plan - All Plans | $235 | 226% |
| Blue Shield Non Epn | $248 | 239% |
| Healthcare Partners- All Plans | $277 - $515 | 267% |
| UnitedHealthcare | $277 - $618 | 267% |
| Cigna | $281 - $580 | 271% |
| Centivo - All Plans | $294 | 283% |
| Aetna | $298 | 287% |
| Heritage Commercial - All Other Plans | $310 | 299% |
| Heritage Sr | $315 | 303% |
| Healthnet - All Other Plans | $330 - $1,153 | 318% |
| First Health- All Plans | $339 | 327% |
| Western Growers/Pinnacle - All Plans | $339 | 327% |
| Phcs- All Plans | $380 | 366% |
| Scan Mcr Adv - All Plans | $380 | 366% |
| Beech Street - All Plans | $438 | 422% |
| Choicecare - All Plans | $438 | 422% |
| Corvel- All Plans | $467 | 450% |
| Health Mgmt Network - All Plans | $496 | 478% |
| Kaiser - All Plans | $496 | 478% |
| Three Rivers - All Plans | $496 | 478% |
| Alignment Hp Mcr Adv - All Plans | $584 | 563% |
| Healthnet Mcr Adv | $829 | 799% |