CMS Price Transparency Data

Group therapy session

Facility: Mercy Hospital of Folsom

Billing Code: 90853 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$162

about 1.6× the $104 Medicare rate · typically $59–$235

modeled estimate · not a bill or quote

What this hospital charges insurers

$127

Below the fair price — a good deal

about $35 under the fair price · 1.2× Medicare

Medicare pays $104 Fair price $162 This hospital $127 Cash price $109 Hospital's list price $281

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 $127

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 $162 (about 1.6× the $104 Medicare rate). Mercy Hospital of Folsom charges insurers about $127, or about $109 in cash — below the fair price — a good deal. Located in Folsom, CA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana✓ Kaiser Permanente Cigna

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
UnitedHealthcaremajor	$4 - $312	4%
Blue Cross Blue Shieldmajor	$9 - $125	9%
Aetnamajor	$122	118%
Humanamajor	$122	118%
Kaiser Permanentemajor	$102 - $246	98%
Health Net	$15	14%
Molina	$12	12%
+ 5 smaller / regional plans	$7 - $250

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 (about 109), 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 Mercy Hospital of Folsom 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 Mercy Hospital of Folsom

Compare: Group therapy session at other CA hospitals

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