CMS Price Transparency Data

Group therapy session

Facility: The Women's Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $34
Cash Discount Price: $42
vs. Medicare Baseline: 0.33x Medicare

The contracted insurance negotiated median rate for a Group therapy session at The Women's Hospital is $34. 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 0.33x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $34 (33%)

Cash: $42 (40% of Medicare)

Ins. Median: $34 (33% 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	$19 - $44	18%
Humana	$19 - $79	18%
Passport Molina Ky	$19	18%
UnitedHealthcare	$19 - $79	18%
Wellcare Ky	$19 - $79	18%
Blue Cross Blue Shield	$23 - $291	22%
Caresource Hip	$23	22%
Caresource In	$23	22%
Mdwise Hip	$23	22%
Mhs Behavioral	$23	22%
Caresource	$24 - $79	23%
Iu Health	$24 - $79	23%
Meridian Health Il	$24 - $79	23%
Mhs	$24 - $79	23%
Molina Il	$24 - $79	23%
Molina Ky	$24 - $79	23%
Molina Ky Dual	$24 - $79	23%
Ambetter / Centene	$27 - $123	26%
Immergrun	$28	27%
Caresource Marketplace (Just4Me)	$31 - $119	30%
Patoka Valley Health Care (80/20 Plan)	$31	30%
Patoka Valley Health Care (90/10 Plan)	$31	30%
Amish	$32 - $42	31%
Hst	$32 - $119	31%
Alliance Coal	$33	32%
Allied National/Zelis - Freedom Plan	$33 - $195	32%
Claimdoc	$34 - $115	33%
Chamber Care	$35	34%
Encorecombined	$35	34%
Encoreprime	$35	34%
One Care	$36	35%
Hope Trust	$38 - $131	37%
Noncontracted	$38 - $127	37%
Self Pay	$42	40%
Cigna	$44	42%
Claritev (Formerly Phcs/Mulitplan)	$44	42%
First Health/Coventry	$44	42%
Healthlink	$44	42%
Sagamore	$44	42%
Center Care	$72	69%

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 The Women's 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.