CMS Price Transparency Data

Group therapy session

Facility: Coastal Communities Hospital

Billing Code: 90853 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$125

about 1.2× the $104 Medicare rate · typically $77–$144

modeled estimate · not a bill or quote

What this hospital charges insurers

$131

About the fair price

about $6 over the fair price · 1.3× Medicare

Medicare pays $104 Fair price $125 This hospital $131 Cash price $1,419 Hospital's list price $1,419

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 $131

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Group therapy session is about $125 (about 1.2× the $104 Medicare rate). Coastal Communities Hospital charges insurers about $131, or about $1,419 in cash — about the fair price. Located in Santa Ana, CA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser 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
UnitedHealthcaremajor	$130	125%
Blue Cross Blue Shieldmajor	$130 - $495	125%
Aetnamajor	$156 - $1,394	150%
Cignamajor	$150 - $1,655	145%
Humanamajor	$130	125%
Kaiser Permanentemajor	$5 - $1,568	5%
Health Net	$130 - $1,859	125%
Presbyterian	$5 - $130	5%
Sentara	$7 - $131	7%
+ 47 smaller / regional plans	$4 - $2,546

Government programs also on file: Medicaid, Military & VA.

Excludes 12 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 1,419), 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 Coastal Communities Hospital 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 Coastal Communities Hospital

Compare: Group therapy session at other CA hospitals

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