CMS Price Transparency Data

Group therapy session

Facility: Atrium Health Floyd Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $204
Cash Discount Price: $319
vs. Medicare Baseline: 1.97x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Atrium Health Floyd Medical Center is $204. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $319. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.97x the Medicare baseline. Located in 304 Turner McCall Boulevard, Rome, GA.

Cash / Self-Pay

$319

Average discount available for prompt cash payment at this facility.

Insurance Median

$204

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: $319 (307%)

Insurance Median: $204 (197%)

Cash: $319 (307% of Medicare)

Ins. Median: $204 (197% 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
Amerigroup	$54 - $161	52%
Caresource	$54 - $163	52%
Peach State Health Plan	$54 - $163	52%
Awc Networks	$62 - $186	60%
Oscar Health Plan	$62 - $334	60%
Blue Cross Blue Shield	$90 - $716	87%
Cigna	$90 - $573	87%
Georgia Assurance	$90	87%
Humana	$90 - $621	87%
UnitedHealthcare	$90 - $716	87%
Aetna	$91 - $649	88%
Wellcare	$92	89%
Clover	$93	90%
Alliant Health Plans	$128 - $382	123%
Ambetter / Centene	$135	130%
Occunet	$135	130%
Beacon	$160 - $478	154%
Evernorth	$160 - $478	154%
Multiplan	$223 - $668	215%
Beech Street	$249 - $745	240%
Private Health Care Systems	$271 - $812	261%

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 $319.
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 Atrium Health Floyd Medical Center 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.