CMS Price Transparency Data

Group therapy session

Facility: Northwest Health-La Porte

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $108
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Northwest Health-La Porte is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.04x the Medicare baseline. Located in 1007 Lincolnway, La Porte, IN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$108

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%)
Insurance Median: $108 (104%)
Ins. Median: $108 (104% 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
One Call $24 23%
Caresource $61 - $80 59%
Blue Cross Blue Shield $80 - $438 77%
Humana $80 - $106 77%
Managed Health Services $80 - $215 77%
Medicaid / KanCare $80 77%
Mhs $80 77%
UnitedHealthcare $80 77%
Tricare $102 98%
Aetna $106 102%
Medicare (plans) $106 102%
Node Champva $107 103%
Node Devoted Health Mcr Adv $108 104%
Node Hospice Non Par Agree $108 104%
Node Va $108 104%
Va Choice Program $108 104%
Indiana Dept Of Correction $112 108%
Node Pphp Mcr Adv $113 109%
Us Department Of Labor $135 130%
Encore $194 187%
Prime Health In Work Comp $194 187%
In Wc $215 207%
Lutheran Network $215 207%
Encore Kba Epo $258 249%
Magnacare Ma $264 254%
Encore Kba Ppo $323 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1007 Lincolnway, La Porte, IN 46350
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals