CMS Price Transparency Data

Group therapy session

Facility: Stanford Health Care Tri-Valley

Billing Code: 90853 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$233

about 2.2× the $104 Medicare rate · typically $99–$451

modeled estimate · not a bill or quote

What this hospital charges insurers

$111

Below the fair price — a good deal

about $122 under the fair price · 1.1× Medicare

Medicare pays $104 Fair price $233 This hospital $111

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $20 Priciest $111

Black dot = this hospital, among the 9 CA hospitals with a price for this procedure. Full list below.

A fair price for a Group therapy session is about $233 (about 2.2× the $104 Medicare rate). Stanford Health Care Tri-Valley charges insurers about $111 — below the fair price — a good deal. Located in Pleasanton, CA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

1 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield UnitedHealthcareAetnaCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Blue Cross Blue Shieldmajor	$73 - $237	70%
Health Net	$149	144%

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90853.

Insurance Before you use insurance

Call your insurance company to confirm Stanford Health Care Tri-Valley is in-network.
Ask your insurer whether prior approval is required for CPT code 90853.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Stanford Health Care Tri-Valley

Compare: Group therapy session at other CA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.