CMS Price Transparency Data

Group therapy session

Facility: Adventist Health Tehachapi Valley

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $29
Cash Discount Price: $19
vs. Medicare Baseline: 0.28x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Adventist Health Tehachapi Valley is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.28x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$19

Average discount available for prompt cash payment at this facility.

Insurance Median

$29

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: $19 (18%)

Insurance Median: $29 (28%)

Cash: $19 (18% of Medicare)

Ins. Median: $29 (28% 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

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medi-Cal	$24	23%
Universal Ipa Mcal Op/Profee Only	$24	23%
Healthnet Mcare	$25	24%
Tricare	$25	24%
UnitedHealthcare	$25 - $32	24%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla	$25	24%
Ah Employee Health Plan - All Plans	$27	26%
Network Providers- All Plans	$27	26%
Cigna	$29	28%
Oscar Health Plan- All Plans	$29	28%
Coventry- All Plans	$30	29%
Western Grwrs/Pinnacle - All Plans	$35	34%
Healthnet- All Other Plans	$36	35%
Centivo - All Plans	$37	36%
Aetna	$45	43%
Blue Cross Blue Shield	$62	60%
Blue Shield Epn- All Other Plans	$64	62%
Blue Shield Non-Epn	$68	66%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $19.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90853.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Tehachapi Valley is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90853.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.