CMS Price Transparency Data

Group therapy session

Facility: Alvarado Parkway Institute Behavioral Health Syste

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $369
Cash Discount Price: $375
vs. Medicare Baseline: 3.56x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Alvarado Parkway Institute Behavioral Health Syste is $369. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $375. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 3.56x the Medicare baseline. Located in 7050 Parkway Drive, La Mesa, CA.

Cash / Self-Pay

$375

Average discount available for prompt cash payment at this facility.

Insurance Median

$369

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: $375 (361%)

Insurance Median: $369 (356%)

Cash: $375 (361% of Medicare)

Ins. Median: $369 (356% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 356% of the Medicare baseline (a markup of 256%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$229 - $408	221%
Medicare (plans)	$250 - $539	241%
Molina Healthcare\|Managed Care	$250 - $375	241%
Healthnet\|Contracted_Plans	$288 - $489	277%
Cigna	$334 - $533	322%
Aetna	$345 - $596	332%
Tricare	$346 - $461	333%
Kaiser\|Contracted_Plans	$349 - $479	336%
Carelon\|Contracted_Plans	$350 - $400	337%
Sharp Healthcare\|Contracted_Plans	$363 - $539	350%
UnitedHealthcare	$363 - $539	350%

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 $375.
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 Alvarado Parkway Institute Behavioral Health Syste 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.