CMS Price Transparency Data

Group therapy session

Facility: Davis County Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $186
  • Cash Discount Price: $310
  • vs. Medicare Baseline: 1.79x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Davis County Hospital is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $310. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.79x the Medicare baseline. Located in 509 North Madison Street, Bloomfield, IA.
Cash / Self-Pay
$310

Average discount available for prompt cash payment at this facility.

Insurance Median
$186

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: $310 (299%)
Insurance Median: $186 (179%)
Cash: $310 (299% of Medicare)
Ins. Median: $186 (179% 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
Aetna $155 149%
Choicecare Mcr Adv $167 161%
Home State Hlth Exch - All Other Plans $167 161%
Home State Hlth Mcr $167 161%
Mt Carmel Hp-All Plans $167 161%
Tricare $167 161%
Amerigroup Mcr Adv-All Other Plans $171 165%
American Hp Mcr Adv-All Plans $176 170%
Home State Hlth Mcaid $186 179%
Iowa Total Care Mcaid-All Plans $190 183%
Amerigroup Mcaid $193 186%
Molina Mcaid-All Plans $193 186%
Midlands Choice - All Plans $217 209%
Preferred Hlth Choices - All Plans $232 224%
Blue Cross Blue Shield $252 - $278 243%
Choicecare Comm - All Other Plans $294 283%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 North Madison Street, Bloomfield, IA 52537
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals