CMS Price Transparency Data

Group therapy session

Facility: Perry County Memorial Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $154
Cash Discount Price: $174
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Perry County Memorial Hospital is $154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.48x the Medicare baseline. Located in 8885 Sr 237, Tell City, IN.

Cash / Self-Pay

$174

Average discount available for prompt cash payment at this facility.

Insurance Median

$154

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: $174 (168%)

Insurance Median: $154 (148%)

Cash: $174 (168% of Medicare)

Ins. Median: $154 (148% 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
Medicaid / KanCare	$57 - $249	55%
Veterans Administration	$62 - $249	60%
Bc 130	$65 - $199	63%
Group Insurance	$65 - $249	63%
Medicare (plans)	$65	63%
Workers Compensation	$124	119%
Nsa	$146 - $154	141%
Guarantor Liable	$174 - $249	168%
Pcmh Insurnace	$194 - $249	187%
Secondary Insurance	$199	192%
UnitedHealthcare	$199	192%
Operating Engineers	$212	204%
Boilermakers Healthcare	$217	209%
Cigna	$217	209%
Great West	$217 - $249	209%
Sagxxxx	$217	209%
Champus	$249	240%
Ngs American, Inc	$249	240%
Patoka Valley	$249	240%
Southwire	$249	240%
Tricare	$249	240%
Wausau Benefits	$249	240%

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 $174.
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 Perry County Memorial 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.