CMS Price Transparency Data

Group therapy session

Facility: Northwestern Medicine Delnor Community Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $143
Cash Discount Price: $460
vs. Medicare Baseline: 1.38x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Northwestern Medicine Delnor Community Hospital is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $460. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.38x the Medicare baseline. Located in 300 Randall Rd, Geneva, IL.

Cash / Self-Pay

$460

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $460 (443%)

Insurance Median: $143 (138%)

Cash: $460 (443% of Medicare)

Ins. Median: $143 (138% 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
Blue Cross Blue Shield	$13 - $675	13%
Aetna	$15 - $820	14%
Cigna	$20 - $966	19%
UnitedHealthcare	$43 - $1,208	41%
Carelon Behavioral Health [159]	$45 - $60	43%
Health'S Finest Network [126]	$45 - $1,027	43%
First Health Plan [6034]	$56 - $834	54%
Healthlink [125]	$57 - $761	55%
The Alliance [1703]	$58 - $776	56%
Multiplan/Phcs [142]	$68 - $1,208	66%
Compsych [112]	$72 - $966	69%
Beechstreet [176]	$81 - $1,087	78%

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 $460.
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 Northwestern Medicine Delnor Community Hospital 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.