CMS Price Transparency Data

Group therapy session

Facility: HCA Florida Memorial Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $174
Cash Discount Price: $623
vs. Medicare Baseline: 1.68x Medicare

The contracted insurance negotiated median rate for a Group therapy session at HCA Florida Memorial Hospital is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $623. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.68x the Medicare baseline. Located in 3625 University Blvd S, Jacksonville, FL.

Cash / Self-Pay

$623

Average discount available for prompt cash payment at this facility.

Insurance Median

$174

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: $623 (600%)

Insurance Median: $174 (168%)

Cash: $623 (600% of Medicare)

Ins. Median: $174 (168% 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
City Of Jacksonville	$30 - $225	29%
Corvel Corporation	$30 - $225	29%
Prime Health	$31 - $229	30%
Optimum Healthcare	$52	50%
Avmed	$75 - $174	72%
Simply Healthcare	$79 - $96	76%
United	$80	77%
Oscar	$100	96%
Aetna	$107 - $187	103%
Positive Healthcare	$137	132%
Cigna	$149 - $176	144%
Molina Healthcare	$168	162%
Centurion	$173	167%
Humana	$181	174%
Corizon	$187	180%
Plotkin Health	$312	301%
Multiplan	$486 - $530	468%
Evolutions Healthcare	$498 - $530	480%
Ppo Next	$530	511%
Novanet	$561	541%

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 $623.
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 Memorial 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.