Group therapy session
Facility: North Shore Medical Center
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $101
- Cash Discount Price: $288
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $9 - $288 | 9% |
| Oscar Health Plan Hix | $18 | 17% |
| Imagine Health | $29 | 28% |
| Healthsun Health Plans | $30 - $94 | 29% |
| Self Pay/Uninsured | $36 - $112 | 35% |
| Employer Direct Healthcare | $37 - $91 | 36% |
| Bc/Bs Of Fl Network Blue | $41 | 40% |
| Bc/Bs Myblue Hmo Hix | $44 | 42% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $44 | 42% |
| Bc/Bs Of Fl Health Options Hmo | $44 | 42% |
| Bc/Bs Of Fl Simplyblue | $47 | 45% |
| Bc/Bs Of Fl Ppo | $49 | 47% |
| Cigna | $50 - $144 | 48% |
| Avmed Broad Network | $61 | 59% |
| Veterans Administration Mill Bill | $63 | 61% |
| Centurion Prison | $72 - $112 | 69% |
| Medicaid / KanCare | $72 - $288 | 69% |
| Medicare (plans) | $81 - $288 | 78% |
| Humana | $86 - $115 | 83% |
| Leon Health Inc | $89 | 86% |
| Devoted Health | $90 | 87% |
| Tricare | $90 | 87% |
| UnitedHealthcare | $90 | 87% |
| Hospice Other | $91 | 88% |
| Veterans Administration Vaccn | $91 | 88% |
| Longevity Health Plan | $96 | 92% |
| Florida Pace Centers | $107 | 103% |
| Bright Health Management Commercial | $109 | 105% |
| Bc/Bs Of Fl Phs | $149 | 144% |
| Beacon Health Strategies Commercial | $150 - $288 | 145% |
| New Directions Behavioral Health Commercial | $151 | 145% |
| New Directions Behavioral Health Exchange | $151 | 145% |
| Avmed Exchange | $159 | 153% |
| Ambetter / Centene | $168 | 162% |
| Magellan Behavioral Health | $173 | 167% |
| Molina Marketplace Program Exchange | $173 | 167% |
| Auto Insurance | $182 | 175% |
| Avmed Select Network | $186 | 179% |
| Dimensions International | $187 | 180% |
| Amerihealth Caritas Next Exchange | $196 | 189% |
| First Health | $196 | 189% |
| Dimension Health Ppo | $216 | 208% |
| Dimension Health Wc | $216 | 208% |
| Workers Compensation | $216 | 208% |
| Commercial Non-Contracted | $288 | 277% |
| Self Pay - Mcd Pending 100 Percent | $288 | 277% |
| Single Case Agreement | $288 | 277% |
| United Behavioral Health Psych | $288 | 277% |