CMS Price Transparency Data

Group therapy session

Facility: Gibson General 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 Gibson General 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 1808 Sherman Drive, Princeton, 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
Blue Cross Blue Shield	$23 - $34	22%
Caresource	$23	22%
Mdwise Plans	$23	22%
Mhs	$23	22%
UnitedHealthcare	$23 - $45	22%
Aetna	$24 - $44	23%
Caresource Just For Me	$24	23%
Medicare (plans)	$24	23%
Meridiancomplete (Il)	$24	23%
Mytruadvantage	$24	23%
Va Ccn	$24	23%
Ambetter / Centene	$30	29%
Caresource In Marketplace	$31	30%
Alliance Coal	$33	32%
Claimdoc	$33	32%
Medicaid / KanCare	$34	33%
Meridiancare (Il)	$34	33%
Meridianhealth (Il)	$34	33%
Chambercare	$35	34%
Encircle/Encore Combined	$35	34%
Encircle/Encore Prime	$35	34%
Deaconess Onecare	$36 - $193	35%
Hopetrust	$36	35%
Hstechnology	$36	35%
Noncontracted	$38	37%
Ky Racing Health & Welfare Fund	$42	40%
Self-Pay	$42	40%
Cigna	$44	42%
First Health	$44	42%
Healthlink Hmo	$44	42%
Healthlink Ppo	$44	42%
Sagamore (Ppo, Oap-Open Access Plus, Epo, Choice Fund Oap+)	$44	42%
Gibson County Sheriff	$102	98%
Integrated Health	$108	104%
Principal Health Care	$108	104%

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 Gibson General 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.