CMS Price Transparency Data

Group therapy session

Facility: Deaconess Illinois Crossroads

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $44
Cash Discount Price: $42
vs. Medicare Baseline: 0.42x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Deaconess Illinois Crossroads is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.42x the Medicare baseline. Located in 8 Doctors Park Rd, Mount Vernon, IL.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $42 (40%)

Insurance Median: $44 (42%)

Cash: $42 (40% of Medicare)

Ins. Median: $44 (42% 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
Aetna	$24 - $98	23%
Blue Cross Blue Shield	$24 - $96	23%
Humana	$24 - $96	23%
Meridian Health Plan	$24 - $96	23%
Molina Healthcare Of Illinois	$24 - $97	23%
Mytru Advantage	$24 - $96	23%
Umwa	$24 - $96	23%
UnitedHealthcare	$24 - $96	23%
Wellcare	$24 - $96	23%
Healthlink	$31 - $34	30%
Alliance Coal	$33 - $159	32%
Deaconess Onecare	$36	35%
Alter-Net Medical Services, Inc.	$38 - $275	37%
Noncontracted	$38 - $154	37%
Self-Pay	$42	40%
Cigna	$47	45%
Prime Health Services	$90	87%
Care Improvement Plus	$98	94%
Guardian Resources, Inc.	$101	97%
Healthcare'S Finest Network (Hfn)	$102	98%
Medicalcontrol Network Solutions	$102	98%
National Provider Network	$102	98%
Three Rivers Provider Network	$104	100%
Beech Street	$106	102%
Hope Trust	$275	265%

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 $42.
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 Deaconess Illinois Crossroads 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.