CMS Price Transparency Data

Group therapy session

Facility: Emory University Hospital Midtown

Billing Code: 90853 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$100

about 1.0× the $104 Medicare rate · typically $62–$159

modeled estimate · not a bill or quote

What this hospital charges insurers

$106

About the fair price

about $6 over the fair price · 1.0× Medicare

Medicare pays $104 Fair price $100 This hospital $106 Cash price $351 Hospital's list price $351

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

Highest price of the 9 GA hospitals we have prices for — worth calling around.

Cheapest $27 Priciest $106

Black dot = this hospital, among the 9 GA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Group therapy session is about $100 (about 1.0× the $104 Medicare rate). Emory University Hospital Midtown charges insurers about $106, or about $351 in cash — about the fair price. Located in Atlanta, GA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna UnitedHealthcareHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Blue Cross Blue Shieldmajor	$104	100%
Aetnamajor	$105	101%
Cignamajor	$106	102%
Ambetter (Centene)	$219	211%
Clover Health	$108	104%
Devoted Health	$103	99%
WellCare	$109	105%

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 351), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90853.

Insurance Before you use insurance

Call your insurance company to confirm Emory University Hospital Midtown is in-network.
Ask your insurer whether prior approval is required for CPT code 90853.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Emory University Hospital Midtown

Compare: Group therapy session at other GA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.