CMS Price Transparency Data

Group therapy session

Facility: Sarah D Culbertson Memorial Hospital

Billing Code: 90853 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$108

about 1.0× the $104 Medicare rate · typically $30–$263

modeled estimate · not a bill or quote

Medicare pays $104 Fair price $108 Cash price $181 Hospital's list price $201

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$86 - $181	83%
Blue Cross Blue Shieldmajor	$82 - $769	79%
Aetnamajor	$88 - $769	85%
Cignamajor	$149	144%
Humanamajor	$86	83%
HealthLink	$181	174%
Meridian	$769	741%
Molina	$86 - $769	83%
+ 4 smaller / regional plans	$181

Excludes 7 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 181), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90853.

Insurance Before you use insurance

Call your insurance company to confirm Sarah D Culbertson Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 90853.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Sarah D Culbertson Memorial Hospital

Compare: Group therapy session at other IL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.