CMS Price Transparency Data

Group therapy session

Facility: UW Health

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $180
  • Cash Discount Price: $133
  • vs. Medicare Baseline: 1.73x Medicare
The contracted insurance negotiated median rate for a Group therapy session at UW Health is $180. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $133. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.73x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.
Cash / Self-Pay
$133

Average discount available for prompt cash payment at this facility.

Insurance Median
$180

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: $133 (128%)
Insurance Median: $180 (173%)
Cash: $133 (128% of Medicare)
Ins. Median: $180 (173% 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
Blue Cross Blue Shield $48 - $415 46%
Quartz Fully Insured $81 - $291 78%
Aetna $104 - $606 100%
Humana $104 100%
Medicare (plans) $104 - $114 100%
Mychoice Wi Medical Adv $104 100%
UnitedHealthcare $104 - $645 100%
Ecoh $118 - $660 114%
Hfn $118 - $660 114%
Alliance Premier Network $127 - $458 122%
Quartz Aso $127 - $458 122%
The Alliance $163 - $589 157%
Wps Ppo $180 - $649 173%
Cigna $186 - $669 179%
Beloit Healt System $210 - $757 202%
Mercycare $217 - $783 209%
First Health/Coventry $229 - $825 221%
Health Payment Systems $272 - $979 262%
Healthsmart $272 - $979 262%
Sheboygan Employers Health Network $290 - $1,044 279%
Multiplan $324 - $1,167 312%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 East State Street, Rockford, IL 61104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals