CMS Price Transparency Data

Group therapy session

Facility: Kootenai Health

Billing Code: 90853 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$55

about 0.5× the $104 Medicare rate · typically $30–$88

modeled estimate · not a bill or quote

What this hospital charges insurers

$30

Below the fair price — a good deal

about $25 under the fair price · 0.3× Medicare

Medicare pays $104 Fair price $55 This hospital $30 Cash price $209 Hospital's list price $278

How we calculate the fair BaseRate →

How this hospital compares to other ID hospitals

One of the lower prices — 4 of 5 other ID hospitals charge more for the same procedure.

Cheapest $24 Priciest $239

Black dot = this hospital, among the 6 ID 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 $55 (about 0.5× the $104 Medicare rate). Kootenai Health charges insurers about $30, or about $209 in cash — below the fair price — a good deal. Located in Coeur D'Alene, ID.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser 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
UnitedHealthcaremajor	$24 - $276	23%
Blue Cross Blue Shieldmajor	$24 - $276	23%
Aetnamajor	$25 - $255	24%
Cignamajor	$204 - $255	197%
Humanamajor	$24 - $105	23%
Kaiser Permanentemajor	$32 - $378	31%
Molina	$14 - $114	13%
PacificSource	$24 - $251	23%
+ 5 smaller / regional plans	$14 - $266

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 209), 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 Kootenai Health 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 Kootenai Health

Compare: Group therapy session at other ID hospitals

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