CMS Price Transparency Data

Group therapy session

Facility: St Francis Hospital - Interquest

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $210
Cash Discount Price: $186
vs. Medicare Baseline: 2.02x Medicare

The contracted insurance negotiated median rate for a Group therapy session at St Francis Hospital - Interquest is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $186. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.02x the Medicare baseline. Located in 10860 New Allegiance Dr, Colorado Springs, CO.

Cash / Self-Pay

$186

Average discount available for prompt cash payment at this facility.

Insurance Median

$210

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: $186 (179%)

Insurance Median: $210 (202%)

Cash: $186 (179% of Medicare)

Ins. Median: $210 (202% 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 202% of the Medicare baseline (a markup of 102%). 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
Aetna	$24 - $256	23%
Blue Cross Blue Shield	$24 - $409	23%
Cigna	$24 - $279	23%
Devoted Health	$24	23%
Humana	$24	23%
Innovage	$24	23%
Kaiser	$24 - $212	23%
Medicare (plans)	$24	23%
Rocky Mountain Pace	$24	23%
UnitedHealthcare	$24 - $270	23%
Direct To Employer	$126 - $153	121%
United Colorado Doctor'S Plan	$174	168%
Centura Employee Plan	$232	224%
Multiplan	$325 - $395	313%
Co Community Health Alliance	$375	361%

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 $186.
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 St Francis Hospital - Interquest 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.