CMS Price Transparency Data

Group therapy session

Facility: HCA Florida West Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $227
Cash Discount Price: $813
vs. Medicare Baseline: 2.19x Medicare

The contracted insurance negotiated median rate for a Group therapy session at HCA Florida West Hospital is $227. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $813. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.19x the Medicare baseline. Located in 8383 N Davis Hwy, Pensacola, FL.

Cash / Self-Pay

$813

Average discount available for prompt cash payment at this facility.

Insurance Median

$227

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: $813 (783%)

Insurance Median: $227 (219%)

Cash: $813 (783% of Medicare)

Ins. Median: $227 (219% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 219% of the Medicare baseline (a markup of 119%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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 - $216	29%
Prime Health	$31 - $221	30%
Careworks (Rockport Community)	$32 - $227	31%
Oscar	$89	86%
Freedom Health	$103	99%
Aetna	$124 - $244	119%
Simply	$125	120%
Simply Healthcare	$136	131%
Cigna	$141 - $337	136%
Molina Healthcare	$154 - $260	148%
Humana	$163	157%
United	$175 - $366	169%
Avmed	$195 - $406	188%
Pensacola Christian	$325	313%
Plotkin Health	$406	391%
Prime Health Sheriff	$406	391%
Evolutions Healthcare	$528 - $691	509%
Multiplan	$634 - $691	611%
Evernorth	$650	626%
Ppo Next	$691	666%
Novanet	$732	705%

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 $813.
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 West 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.