CMS Price Transparency Data

Group therapy session

Facility: HCA Florida Osceola Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $137
Cash Discount Price: $488
vs. Medicare Baseline: 1.32x Medicare

The contracted insurance negotiated median rate for a Group therapy session at HCA Florida Osceola Hospital is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $488. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.32x the Medicare baseline. Located in 700 West Oak Street, Kissimmee, FL.

Cash / Self-Pay

$488

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $488 (470%)

Insurance Median: $137 (132%)

Cash: $488 (470% of Medicare)

Ins. Median: $137 (132% 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.

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
Corvel Corporation	$30 - $225	29%
Prime Health	$31 - $230	30%
Careworks (Rockport Community)	$32 - $237	31%
Freedom Health	$35	34%
Optimum	$35	34%
Avmed	$39 - $244	38%
Simply	$75	72%
Oscar	$78	75%
Simply Healthcare	$81	78%
Cigna	$85	82%
Molina Healthcare	$93 - $132	90%
Aetna	$97 - $146	93%
Humana	$137	132%
United	$163 - $219	157%
Plotkin Health	$244	235%
Prime Health Sheriff	$244	235%
Multiplan	$366 - $414	353%
Ppo Next	$414	399%
Novanet	$439	423%

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 $488.
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 Florida Osceola Hospital 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.