CMS Price Transparency Data

Group therapy session

Facility: Wabash General Hospital 1

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $135
  • Cash Discount Price: $130
  • vs. Medicare Baseline: 1.30x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Wabash General Hospital 1 is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.30x the Medicare baseline. Located in 1418 College Drive, Mount Carmel, IL.
Cash / Self-Pay
$130

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $130 (125%)
Insurance Median: $135 (130%)
Cash: $130 (125% of Medicare)
Ins. Median: $135 (130% 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
Aetna $48 - $569 46%
Healthlink Hmo $51 - $130 49%
Blue Cross Blue Shield $55 - $569 53%
Cigna $55 - $140 53%
Encore Combined Ip/Op Only $55 - $140 53%
Hope Trust - All Plans $55 - $140 53%
UnitedHealthcare $58 - $204 56%
Health Alliance Mcr Adv - All Plans $59 - $208 57%
Healthlink Ppo - All Other Plans $59 - $149 57%
Phcs - All Plans $59 - $149 57%
Health Smart - All Plans $62 - $158 60%
Hfn - All Plans $62 - $158 60%
Multiplan - All Plans $62 - $158 60%
Siho Network - All Plans $62 - $158 60%
Encore Health Network Ip/Op Only - All Other Plans $66 - $168 64%
Meridian Mcaid - All Plans $569 548%
Molina Mcaid - All Plans $569 548%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1418 College Drive, Mount Carmel, IL 62863
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals