Group therapy session
Facility: Boulder Community Health
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $350
- Cash Discount Price: $484
- vs. Medicare Baseline: 3.37x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 337% of the Medicare baseline (a markup of 237%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Colorado Community Health Alliance (Ccha) | $24 | 23% |
| Humana | $24 - $93 | 23% |
| UnitedHealthcare | $24 - $230 | 23% |
| Medicaid / KanCare | $25 - $350 | 24% |
| Rocky Mountain Health Maintenance Organization | $25 - $250 | 24% |
| Colorado Access | $27 - $400 | 26% |
| Aetna | $29 - $1,265 | 28% |
| Blue Cross Blue Shield | $29 - $865 | 28% |
| Clear Spring | $29 - $96 | 28% |
| Devoted Health | $29 - $581 | 28% |
| Health Spring | $29 - $93 | 28% |
| Medicare (plans) | $29 - $552 | 28% |
| Beech Street Community Medical Associates | $37 | 36% |
| Multiplan | $37 - $1,004 | 36% |
| Phcs | $37 - $1,004 | 36% |
| Cigna | $39 - $1,162 | 38% |
| Select Health Colorado Public Option | $40 - $552 | 39% |
| Select Health Value Network | $40 - $552 | 39% |
| Kaiser Ppo | $44 - $506 | 42% |
| Kaiser Public Option | $44 - $436 | 42% |
| Kaiser | $129 - $504 | 124% |
| Mines And Associates | $250 - $1,235 | 241% |
| Rocky Mountain Health Maintenance Organization Private Plan | $337 - $350 | 325% |
| Integrated Health Plans Bch | $361 - $1,090 | 348% |
| Casualty Management Network, Prime Health Services Behavioral Health | $409 - $1,235 | 394% |
| Three Rivers Provider Network | $409 - $1,235 | 394% |
| Zelis (Profee) | $409 - $1,235 | 394% |
| Casualty Management Network, Prime Health Services Community Medical Associates | $433 - $1,308 | 417% |
| National Preferred Provider Network | $433 - $1,308 | 417% |
| Rockport Healthcare Group Community Medical Associates | $433 - $1,308 | 417% |
| Usa | $433 - $1,308 | 417% |
| Rockport Healthcare Group Bch | $447 - $1,351 | 431% |
| Health Payors Organization | $457 - $1,380 | 440% |
| Health Management Network Bch Community Medical Associates | $462 - $1,395 | 445% |
| Health Management Network Community Medical Associates | $462 - $1,395 | 445% |
| National Provider Network | $467 - $1,409 | 450% |