Group therapy session
Facility: Menifee Global Medical Center
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $223
- Cash Discount Price: $383
- vs. Medicare Baseline: 2.15x 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 215% of the Medicare baseline (a markup of 115%). 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 |
|---|---|---|
| Lasalle Medical Assoc (Ancillary) Mcal Hmo | $4 | 4% |
| Blue Cross Blue Shield | $5 | 5% |
| Health Net Medi-Cal | $5 | 5% |
| Ic | $5 - $398 | 5% |
| Kaiser Medi-Cal | $5 - $305 | 5% |
| Prospect Health Plan Mcal Hmo | $5 | 5% |
| Molina Medi-Cal | $6 | 6% |
| Altamed Mcal Hmo | $7 | 7% |
| Altamed Mcal/Pace | $7 | 7% |
| Choice Physicians Network | $7 - $875 | 7% |
| Hpn Mcal | $7 | 7% |
| Iehp Medi-Cal | $7 | 7% |
| Tricare | $27 - $122 | 26% |
| Health Net Enhanced Ppo | $44 - $182 | 42% |
| Health Net Comm | $78 - $195 | 75% |
| Prospect Health Plan Comm Hmo | $96 - $176 | 92% |
| Prospect Health Plan Sr Hmo | $96 - $130 | 92% |
| Molina Covered Ca | $109 | 105% |
| Primecare Senior | $128 - $130 | 123% |
| Aetna | $130 - $252 | 125% |
| Altamed Comm Hmo (Ancillary) | $130 - $398 | 125% |
| Altamed Health Services Senior | $130 | 125% |
| Altamed Sr/Pace | $130 | 125% |
| Blue Shield Senior | $130 | 125% |
| Central Health Plan Senior | $130 | 125% |
| Clever Care Health Plan Sr | $130 - $319 | 125% |
| For Your Benefit Senior | $130 | 125% |
| Guidant Health Plan Senior | $130 | 125% |
| Health Net Senior | $130 | 125% |
| Hpn Commercial/Covered Ca | $130 - $182 | 125% |
| Hpn Senior | $130 - $319 | 125% |
| Humana | $130 | 125% |
| Kaiser Senior | $130 - $305 | 125% |
| Lasalle Medical Assoc (Ancillary) Senior | $130 | 125% |
| Managed Health Network Sr | $130 | 125% |
| Medicare (plans) | $130 | 125% |
| Neighborhood Healthcare Pace | $130 | 125% |
| Scan Senior | $130 | 125% |
| Sr Capitation | $130 | 125% |
| UnitedHealthcare | $130 | 125% |
| Veterans Administration | $130 - $239 | 125% |
| Imperial Health Plan Of Ca | $131 - $319 | 126% |
| Lasalle Medical Assoc (Ancillary) Commercial | $131 | 126% |
| Point Comfort Underwriters | $131 | 126% |
| Self Pay/Ab774/Charity Discount | $131 | 126% |
| Velocity | $144 - $229 | 139% |
| Align Senior Care | $146 | 141% |
| Welbehealth Sr/Pace | $146 | 141% |
| Prime Health Services Senior | $150 | 145% |
| Coventry | $156 - $162 | 150% |
| Prime Health Services Wcomp | $156 | 150% |
| Iehp Covered Ca | $163 | 157% |
| Cigna | $165 - $540 | 159% |
| First Health Commercial | $167 - $209 | 161% |
| Three Rivers Wcomp | $170 | 164% |
| Workers Comp Non-Contracted | $174 | 168% |
| Multiplan Ppo | $223 - $279 | 215% |
| Multiplan Wcomp | $223 - $279 | 215% |
| Three Rivers Network | $229 | 221% |
| Primecare Commercial | $249 - $535 | 240% |
| Pnoa-Provider Network Of America | $255 - $318 | 246% |
| Prime Health Services Commercial | $255 - $318 | 246% |
| Managed Health Network | $300 - $425 | 289% |
| Kaiser Commercial | $305 - $398 | 294% |
| Ava Hospice | $319 - $398 | 307% |
| Living Waters Hospice | $319 - $398 | 307% |
| Other Insurance Loa | $319 - $398 | 307% |
| Pacific Valley Hospice | $319 - $398 | 307% |
| Private Pay | $319 - $398 | 307% |
| Silverado Hospice | $319 - $398 | 307% |
| Vna Hospice | $319 - $398 | 307% |
| Blue Shield Epn | $365 | 352% |
| Blue Shield Commercial | $430 | 414% |