CMS Price Transparency Data

Group therapy session

Facility: Northwestern Medicine Central Dupage Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $137
Cash Discount Price: $390
vs. Medicare Baseline: 1.32x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Northwestern Medicine Central Dupage Hospital is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $390. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.32x the Medicare baseline. Located in 25 North Winfield Road, Winfield, IL.

Cash / Self-Pay

$390

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $390 (376%)

Insurance Median: $137 (132%)

Cash: $390 (376% of Medicare)

Ins. Median: $137 (132% 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	$6 - $1,208	6%
Countycare Il Cook Co [1607]	$6 - $83	6%
Medicaid / KanCare	$6 - $83	6%
Aetna	$13 - $696	13%
Cigna	$19 - $966	18%
Health'S Finest Network [126]	$45 - $1,102	43%
UnitedHealthcare	$45 - $1,208	43%
Multiplan/Phcs [142]	$52 - $1,208	50%
Dreyer Med Ipa Advocate [1409]	$54 - $725	52%
Humana	$54 - $1,208	52%
Healthlink [125]	$57 - $761	55%
The Alliance [1703]	$58 - $776	56%
Choicecare [177]	$69 - $925	66%
First Health Plan [6034]	$69 - $929	66%

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 $390.
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 Central Dupage 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.