CMS Price Transparency Data

Group therapy session

Facility: HCA Healthone Mountain Ridge

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $249
Cash Discount Price: $389
vs. Medicare Baseline: 2.40x Medicare

The contracted insurance negotiated median rate for a Group therapy session at HCA Healthone Mountain Ridge is $249. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $389. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.40x the Medicare baseline. Located in 9191 Grant St, Thornton, CO.

Cash / Self-Pay

$389

Average discount available for prompt cash payment at this facility.

Insurance Median

$249

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: $389 (375%)

Insurance Median: $249 (240%)

Cash: $389 (375% of Medicare)

Ins. Median: $249 (240% 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 240% of the Medicare baseline (a markup of 140%). 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	$59	57%
Kaiser	$74	71%
Cigna	$75 - $249	72%
United	$80 - $175	77%
Bright Health	$117	113%
Colorado Program For Children With Special Needs	$132	127%
Pinnacol Workers Comp	$137	132%
Multiplan	$143 - $350	138%
Western Plains Community Health	$253	244%
Northcare	$272	262%
Physician Health Partners	$272	262%
Blue Cross Blue Shield	$288	277%
Colorado Access	$300	289%
Medical Development International	$311	300%
Rocky Mountain Health	$312	301%
Life Source Services	$350	337%
Prime Health	$350	337%

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 $389.
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 Mountain Ridge 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.