CMS Price Transparency Data

Group therapy session

Facility: Baptist Health Medical Center - Jacksonville

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $159
  • Cash Discount Price: $231
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Baptist Health Medical Center - Jacksonville is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $231. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.53x the Medicare baseline. Located in 800 Prudential Dr, Jacksonville, FL.
Cash / Self-Pay
$231

Average discount available for prompt cash payment at this facility.

Insurance Median
$159

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: $231 (223%)
Insurance Median: $159 (153%)
Cash: $231 (223% of Medicare)
Ins. Median: $159 (153% 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.

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
Corvel $27 - $31 26%
Coventry Workers Comp $27 - $31 26%
Non-Contracted $32 - $51 31%
Blue Cross Blue Shield $68 - $220 66%
Aetna $78 - $271 75%
UnitedHealthcare $81 - $178 78%
Community Hospice Of Northeast Florida $92 - $93 89%
Pace $92 - $93 89%
Tomorrow'S Rainbow $92 - $93 89%
Va Ccn $92 - $93 89%
Florida Community Care $97 - $168 93%
Devoted $98 94%
Upmc $102 98%
Avmed $108 - $176 104%
Cigna $132 - $725 127%
Borland Groover $136 131%
Occunet $136 - $170 131%
Northeast Florida State Hospital $142 - $159 137%
Centivo $149 - $978 144%
Amerigroup Of Georgia $153 147%
Caresource Of Georgia $153 - $220 147%
Daniel Memorial $153 147%
Humana $153 - $168 147%
Peach State Health Plan $153 - $220 147%
Capital Health Plan $156 150%
Innovative Healthware Services $159 153%
Simply Healthcare Plans $160 - $183 154%
Simply Healthcare Plans - Cha $160 154%
Amerihealth Caritas $168 162%
Sunshine State Health Plan $168 - $380 162%
United Community Plan $168 162%
Vivida Health $168 162%
Geo Group $170 164%
Molina Healthcare Of Florida $182 175%
Volusia Health Network $186 179%
Watchtower $186 179%
Fscj Student Insurance $203 196%
Suddath Company $214 206%
Medicaid / KanCare $220 212%
Ambetter / Centene $222 - $223 214%
United Behavioral Health $222 - $571 214%
Uf Health Proton Therapy Institute $237 228%
Phcs $254 - $271 245%
Evolutions Healthcare $305 294%
Multiplan $305 294%
Nemours Research $983 947%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Prudential Dr, Jacksonville, FL 32207
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals