CMS Price Transparency Data
Group therapy session
Facility: Coastal Communities Hospital
Billing Code: 90853 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90853
- Insurance Median: $192
- Cash Discount Price: $1,419
- vs. Medicare Baseline: 1.85x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Coastal Communities Hospital is $192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,419. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.85x the Medicare baseline. Located in 2701 S Bristol St, Santa Ana, CA.
Cash / Self-Pay
$1,419
Average discount available for prompt cash payment at this facility.
Insurance Median
$192
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: $1,419 (1367%)
Insurance Median: $192 (185%)
Cash: $1,419 (1367% of Medicare)
Ins. Median: $192 (185% 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.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Kpc Healthcare Inc | $4 - $891 | 4% |
| Altamed Mcal Hmo (Ancillary) | $5 | 5% |
| Healthcare Partners | $5 | 5% |
| Hollywood Presbyterian | $5 - $130 | 5% |
| Kaiser | $5 - $1,568 | 5% |
| Medi-Cal Hmo/Non Contract | $5 | 5% |
| Medicaid / KanCare | $5 | 5% |
| Altamed Health Services | $7 - $130 | 7% |
| Caloptima | $7 - $131 | 7% |
| Choc Health Alliance | $7 | 7% |
| County Of Orange | $7 | 7% |
| Family Choice | $7 | 7% |
| Heritage Provider Network | $7 - $1,528 | 7% |
| Prospect Health Plan | $7 - $891 | 7% |
| Ihhi Reciprocity | $87 - $764 | 84% |
| Champus | $125 | 120% |
| Blue Shield | $130 - $495 | 125% |
| Central Health Plan Of California | $130 | 125% |
| Champion Health Plan | $130 | 125% |
| Citizens Choice Health Plan | $130 | 125% |
| Clever Care Health Plan | $130 | 125% |
| Easy Choice Health Plan | $130 | 125% |
| For Your Benefit | $130 | 125% |
| Health Net | $130 - $1,859 | 125% |
| Healthcare Partners Sr Hmo | $130 | 125% |
| Heritage | $130 | 125% |
| Humana | $130 | 125% |
| Managed Health Network | $130 - $480 | 125% |
| Monarch | $130 | 125% |
| Onecare | $130 | 125% |
| Onecare Connect | $130 | 125% |
| Other Senior Non Contract | $130 | 125% |
| Scan Health Plan | $130 | 125% |
| UnitedHealthcare | $130 | 125% |
| Us Federal Marshall/Department Of Immigration | $130 | 125% |
| Velocity Provider Network Sr | $130 | 125% |
| Verda Health Plan Sr | $130 | 125% |
| Veterans Administration | $130 - $1,910 | 125% |
| Choice Physicians Network | $131 | 126% |
| Imperial Health Plan Of Ca | $131 | 126% |
| Innovative Integrated Health | $131 | 126% |
| Medcare Partners | $131 | 126% |
| Self Pay Ab774/Cbo Use Only | $131 | 126% |
| Us Dept Of Labor | $131 | 126% |
| Victim Of Violent Crime | $131 | 126% |
| Victoria Hospice | $131 - $2,546 | 126% |
| Brand New Day | $146 | 141% |
| Cigna | $150 - $1,655 | 145% |
| Prime Health Srvs | $150 - $2,037 | 145% |
| First Health | $153 - $1,337 | 147% |
| Coventry Auto Network | $156 | 150% |
| Prime Health Srvs/Wc | $156 | 150% |
| Interplan | $158 - $1,910 | 152% |
| Aetna | $159 - $1,394 | 153% |
| Coventry Wc | $162 | 156% |
| County Of Orange/Custody/Advanced Medmgt | $163 | 157% |
| Veterans Evaluation Services | $163 | 157% |
| Multiplan | $170 - $1,782 | 164% |
| Three Rivers | $170 | 164% |
| Velocity National Provider Network Wc | $174 - $1,146 | 168% |
| Workers Comp State Of California | $174 | 168% |
| Magellan | $175 - $1,528 | 169% |
| Staywell/Island Home Ins | $183 - $1,273 | 176% |
| Networks By Design | $204 - $1,782 | 197% |
| Networks By Design Wc | $204 - $1,782 | 197% |
| Healthsmart | $218 - $1,910 | 210% |
| Prime Health | $218 - $1,910 | 210% |
| Three Rivers Network | $229 | 221% |
| Velocity National Provider Network Ppo | $229 | 221% |
| Pnoa-Provider Network Of America | $233 - $2,037 | 224% |
| Prime Health Srvs/Network | $247 - $2,164 | 238% |
| Lucet Behavioral Health Sr | $291 | 280% |
| Other Insurance Loa | $291 - $2,546 | 280% |
| Other Non Contracted Plans | $291 - $2,546 | 280% |
| Private Pay | $291 - $2,546 | 280% |
| Us Behavioral Health Plan | $291 - $2,546 | 280% |
| Vitas Hospice | $291 - $2,546 | 280% |