CMS Price Transparency Data

Group therapy session

Facility: Northwestern Memorial Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $121
Cash Discount Price: $320
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Northwestern Memorial Hospital is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $320. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.17x the Medicare baseline. Located in 251 E Huron St, Chicago, IL.

Cash / Self-Pay

$320

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $320 (308%)

Insurance Median: $121 (117%)

Cash: $320 (308% of Medicare)

Ins. Median: $121 (117% 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
Curaechoice [6100]	$21 - $283	20%
Aetna	$22 - $1,208	21%
Imagine Health [6032]	$24 - $326	23%
Cigna	$27 - $1,208	26%
Blue Cross Blue Shield	$40 - $1,208	39%
Humana	$40 - $604	39%
Global Medical Management Inc [6090]	$52 - $701	50%
Healthlink [125]	$57 - $1,208	55%
Medpartners [6038]	$63 - $846	61%
UnitedHealthcare	$66 - $1,208	64%
Health'S Finest Network [126]	$74 - $184	71%
First Health Plan [6034]	$90 - $1,208	87%
Galaxy Health Network [220]	$90 - $1,208	87%
Multiplan/Phcs [142]	$90 - $1,208	87%

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 $320.
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 Memorial 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.