CMS Price Transparency Data

Group therapy session

Facility: Children's Hospital Colorado

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $214
  • Cash Discount Price: $223
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Children's Hospital Colorado is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $223. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.06x the Medicare baseline. Located in 13123 E 16Th Ave, Aurora, CO.
Cash / Self-Pay
$223

Average discount available for prompt cash payment at this facility.

Insurance Median
$214

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: $223 (215%)
Insurance Median: $214 (206%)
Cash: $223 (215% of Medicare)
Ins. Median: $214 (206% 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 206% of the Medicare baseline (a markup of 106%). 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.

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
Ccha Behavioral Health $8 - $61 8%
Integrated Health Plan $11 - $81 11%
Kaiser $26 - $396 25%
Rocky Mountain Health Plan Behavioral Health $30 - $217 29%
Carelon Behavioral Health $34 - $379 33%
Denver Health Medical Plan $34 - $406 33%
Presbyterian Health Plan $36 - $309 35%
Colorado Access $37 - $60 36%
Colorado Access Behavioral Health $37 - $60 36%
Molina Healthcare Of Nebraska $42 - $298 40%
Molina Healthcare Of New Mexico $42 - $298 40%
Peak Health Alliance/Ebms $42 - $325 40%
Rocky Mountain Health Plan $42 - $352 40%
Healthy Blue Of Nebraska $44 - $314 42%
Humana $46 - $379 44%
UnitedHealthcare $47 - $363 45%
Evernorth Behavioral Health $49 - $352 47%
Interlink National $49 - $406 47%
Centivo $52 - $374 50%
Select Health $53 - $379 51%
Uchealth Plan Administrators $53 - $379 51%
Blue Cross Blue Shield $54 - $406 52%
Aetna $55 - $434 53%
Cigna $55 - $391 53%
Department Of Corrections $59 - $423 57%
Comppsych Behavioral Health $65 - $461 63%
First Choice Health $65 - $461 63%
Midlands Choice $65 - $461 63%
Multiplan $65 - $466 63%
National Preferred Provider Network $65 - $461 63%
Cofinity $68 - $488 66%
First Choice Of The Midwest $68 - $488 66%
Usa Managed Care Organization $68 - $488 66%
First Health Network $70 - $499 67%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13123 E 16Th Ave, Aurora, CO 80045
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens