CMS Price Transparency Data

Group therapy session

Facility: HCA Florida Aventura Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $103
  • Cash Discount Price: $431
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Group therapy session at HCA Florida Aventura Hospital is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $431. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.99x the Medicare baseline. Located in 20900 Biscayne Blvd, Aventura, FL.
Cash / Self-Pay
$431

Average discount available for prompt cash payment at this facility.

Insurance Median
$103

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: $431 (415%)
Insurance Median: $103 (99%)
Cash: $431 (415% of Medicare)
Ins. Median: $103 (99% 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 Corporation $30 - $245 29%
Careworks (Rockport) $31 - $250 30%
Prime Health $31 - $250 30%
Freedom Health $37 - $69 36%
Optimum $37 36%
Avmed $52 - $216 50%
Simply Healthcare Plans $56 54%
Aetna $58 - $129 56%
Simply Healthcare $58 56%
Oscar $69 66%
Amerihealth Caritas $73 70%
Molina $73 - $116 70%
Cigna $91 88%
Humana $91 - $147 88%
Health Sun Health Plan $92 89%
Aids Healthcare $95 - $517 92%
Mmm Of Fl (Health Advantage Plan) $99 95%
United Ppo $102 98%
United $194 187%
Plotkin Health $216 208%
Prime Health Sherriff $216 208%
Medica Healthcare $250 241%
Multiplan $323 - $366 311%
Evernorth Bh $345 332%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 20900 Biscayne Blvd, Aventura, FL 33180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals