CMS Price Transparency Data

Group therapy session

Facility: Sharp Mesa Vista Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $305
Cash Discount Price: $344
vs. Medicare Baseline: 2.94x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Sharp Mesa Vista Hospital is $305. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $344. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.94x the Medicare baseline. Located in 7850 Vista Hill Avenue, San Diego, CA.

Cash / Self-Pay

$344

Average discount available for prompt cash payment at this facility.

Insurance Median

$305

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: $344 (331%)

Insurance Median: $305 (294%)

Cash: $344 (331% of Medicare)

Ins. Median: $305 (294% 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 294% of the Medicare baseline (a markup of 194%). 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
County Medical Services	$64 - $275	62%
Blue Cross Blue Shield	$69 - $367	66%
Health Net	$69 - $725	66%
Allianz Global Assistance	$129 - $376	124%
Blue Shield	$129 - $413	124%
Indian Health Council	$136 - $259	131%
Kaiser	$136 - $450	131%
Molina	$136 - $321	131%
UnitedHealthcare	$136 - $376	131%
Cigna	$140 - $344	135%
Aetna	$184 - $413	177%
Humana	$220 - $344	212%
Managed Health Network	$230 - $367	222%
Community Health Group	$275 - $367	265%
Medi-Cal	$289	278%
Epic Americas	$312 - $344	301%
Interplan	$312	301%
Multiplan	$321	309%

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 $344.
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 Sharp Mesa Vista Hospital 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.