CMS Price Transparency Data

Group therapy session

Facility: Mercyone Waterloo Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $104
  • Cash Discount Price: $311
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Mercyone Waterloo Medical Center is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $311. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.00x the Medicare baseline. Located in 3421 West Ninth Street, Waterloo, IA.
Cash / Self-Pay
$311

Average discount available for prompt cash payment at this facility.

Insurance Median
$104

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: $311 (300%)
Insurance Median: $104 (100%)
Cash: $311 (300% of Medicare)
Ins. Median: $104 (100% 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.

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
Health Choices $27 - $198 26%
Medical Associates $27 - $198 26%
Health Partners $75 - $553 72%
Auxiant $81 - $599 78%
Cigna $81 - $599 78%
Medica $81 - $599 78%
Midlands $81 - $599 78%
Midlands Choice $81 - $599 78%
Aetna $102 - $753 98%
Allied Benefit Systems $102 - $753 98%
Asr Health Benefits $102 - $753 98%
Christian Brother Services $102 - $753 98%
Coventry $102 - $753 98%
First Health $102 - $753 98%
Lucent Health $102 - $753 98%
Luminare Health $102 - $753 98%
Medical Mutual $102 - $753 98%
Meritain $102 - $753 98%
Webtpa $102 - $753 98%
Bcn Domestic $104 100%
Blue Benefit Administrators Of Massachusetts $104 100%
Blue Care Network $104 100%
Blue Cross Blue Shield $104 100%
Blue Distinction Transplant $104 100%
Blue Shield - Ca $104 100%
Blue Shield - Id (Regence) $104 100%
Blue Shield - Ny Highmark Northeastern $104 100%
Blue Shield - Ny Highmark Western $104 100%
Blue Shield - Pa (Highmark) $104 100%
Blue Shield - Wa (Regence) $104 100%
Kaiser Domestic $104 100%
Pre-Employment $104 100%
Wc Domestic $104 100%
UnitedHealthcare $106 - $843 102%
Iowa Dept Of Public Health $114 - $843 110%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3421 West Ninth Street, Waterloo, IA 50702
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals