CMS Price Transparency Data

Group therapy session

Facility: HCA Florida Trinity Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $109
Cash Discount Price: $497
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Group therapy session at HCA Florida Trinity Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $497. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.05x the Medicare baseline. Located in 9330 Sr 54, Trinity, FL.

Cash / Self-Pay

$497

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $497 (479%)

Insurance Median: $109 (105%)

Cash: $497 (479% of Medicare)

Ins. Median: $109 (105% 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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$23	22%
Corvel Corporation	$30 - $228	29%
Rockport Healthcare Group	$30 - $228	29%
Prime Health	$31 - $233	30%
Access 2 Healthcare Physicians Freedom Health	$36	35%
Access 2 Healthcare Physicians Optimum	$36	35%
Freedom Health Care	$39	38%
Optimum Healthcare	$39	38%
Avmed	$40 - $124	39%
Simply Healthcare	$63 - $77	61%
Aetna	$65 - $149	63%
Oscar	$75	72%
United	$82 - $224	79%
Cigna	$90	87%
Molina	$95 - $134	92%
Humana	$139	134%
Plotkin Health	$249	240%
Prime Health Sheriff	$249	240%
Evolutions Healthcare Systems	$298 - $458	287%
Multiplan	$373 - $423	359%

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 $497.
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 Trinity 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.