CMS Price Transparency Data

Group therapy session

Facility: Hca-Healthone DBA Swedish Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $187
Cash Discount Price: $424
vs. Medicare Baseline: 1.80x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Hca-Healthone DBA Swedish Medical Center is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $424. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.80x the Medicare baseline. Located in 501 E Hampden Ave, Englewood, CO.

Cash / Self-Pay

$424

Average discount available for prompt cash payment at this facility.

Insurance Median

$187

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: $424 (409%)

Insurance Median: $187 (180%)

Cash: $424 (409% of Medicare)

Ins. Median: $187 (180% 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
Vail Health	$64	62%
Kaiser	$85 - $137	82%
United	$88 - $191	85%
Cigna	$100 - $271	96%
Bright Health	$127	122%
Pinnacol Workers Comp	$137	132%
Multiplan	$143 - $381	138%
Colorado Program For Children With Special Needs	$186	179%
Western Plains Community Health	$276	266%
Northcare	$297	286%
Physician Health Partners	$297	286%
Colorado Access	$300	289%
Blue Cross Blue Shield	$314	303%
Medical Development International	$339	327%
Prime Health	$381	367%

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 $424.
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 DBA Swedish Medical Center 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.