CMS Price Transparency Data

Group therapy session

Facility: Indiana University Health Tipton Hospital Inc

Billing Code: 90853 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$107

about 1.0× the $104 Medicare rate · typically $30–$227

modeled estimate · not a bill or quote

What this hospital charges insurers

$202

Well above the fair price

about $95 over the fair price · 1.9× Medicare

Medicare pays $104 Fair price $107 This hospital $202 Cash price $98 Hospital's list price $260

How we calculate the fair BaseRate →

How this hospital compares to other IN hospitals

Highest price of the 9 IN hospitals we have prices for — worth calling around.

Cheapest $20 Priciest $202

Black dot = this hospital, among the 9 IN hospitals with a price for this procedure. Full list below.

A fair price for a Group therapy session is about $107 (about 1.0× the $104 Medicare rate). Indiana University Health Tipton Hospital Inc charges insurers about $202, or about $98 in cash — well above the fair price. Located in Tipton, IN.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $107. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$80 - $509	77%
Blue Cross Blue Shieldmajor	$80 - $509	77%
Aetnamajor	$190 - $202	183%
Cignamajor	$202	195%
CareSource	$80 - $509	77%
Health Net	$182 - $202	175%
+ 9 smaller / regional plans	$80 - $509

Excludes 1 rental-network / third-party entry (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 98), 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 Indiana University Health Tipton Hospital Inc 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 Indiana University Health Tipton Hospital Inc

Compare: Group therapy session at other IN hospitals

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