CMS Price Transparency Data

Group therapy session

Facility: HCA Healthone Rose

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $227
Cash Discount Price: $354
vs. Medicare Baseline: 2.19x Medicare

The contracted insurance negotiated median rate for a Group therapy session at HCA Healthone Rose is $227. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $354. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.19x the Medicare baseline. Located in 4567 E 9Th Ave, Denver, CO.

Cash / Self-Pay

$354

Average discount available for prompt cash payment at this facility.

Insurance Median

$227

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: $354 (341%)

Insurance Median: $227 (219%)

Cash: $354 (341% of Medicare)

Ins. Median: $227 (219% 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 219% of the Medicare baseline (a markup of 119%). 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
Vail Health	$54	52%
Cigna	$65 - $227	63%
United	$73 - $159	70%
Bright Health	$106	102%
Pinnacol Workers Comp	$137	132%
Multiplan	$143 - $319	138%
Colorado Program For Children With Special Needs	$159	153%
Western Plains Community Health	$230	222%
Northcare	$248	239%
Physician Health Partners	$248	239%
Blue Cross Blue Shield	$262	252%
Medical Development International	$283	273%
Colorado Access	$300	289%
Rocky Mtn Planned Parenthood	$301	290%
Rocky Mountain Health	$312	301%
Prime Health	$319	307%

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 $354.
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 HCA Healthone Rose 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.