CMS Price Transparency Data

Group therapy session

Facility: University Of Kansas Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $126
  • Cash Discount Price: $41
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Group therapy session at University Of Kansas Hospital is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.21x the Medicare baseline. Located in 4000 Cambridge Street, Kansas City, KS.
Cash / Self-Pay
$41

Average discount available for prompt cash payment at this facility.

Insurance Median
$126

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: $41 (40%)
Insurance Median: $126 (121%)
Cash: $41 (40% of Medicare)
Ins. Median: $126 (121% 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
Larned State Hospital [503200090] $60 58%
Hchsync Centrus Health Direct [503999916] $61 - $71 59%
Blue Cross Blue Shield $78 - $156 75%
Alt Theramatrix [5032000967] $84 81%
Health Plan Inc [503999941] $95 92%
Triwest [503201703] $95 92%
Humana $95 92%
Tricare $95 92%
Cigna $101 - $162 97%
Accarent Health [503999034] $102 98%
Alt Carelon Behavioral Health [503200905] $102 98%
Aetna $105 - $137 101%
Coventry [503200022] $105 - $137 101%
Coresource [503200089] $105 101%
Meritain Health [503200039] $105 - $171 101%
National Assn Letter Carriers [503200019] $112 108%
Php [503200005] $122 - $150 118%
Allied National [503999937] $122 118%
Cerner [503200038] $123 119%
Inter-Americas Insurance [503999032] $123 119%
Geha [503200036] $123 119%
Healthlink [503200007] $123 - $150 119%
Med-Pay [503200040] $123 119%
Alt Wppa [5032000964] $123 119%
Alt Coventry Advantra Mhnet [50311260] $124 119%
Alt Coventry Mhnet [503200030] $124 119%
Mh Net [503999024] $124 119%
Aha-Healthcare Preferred [503200050] $134 129%
First Health [5032000110] $134 129%
Alt Meritain Health [503999911] $137 132%
Correct Care Solutions [50311253] $142 137%
Coeur Plan Services [503301517] $142 137%
Consolidated Billing [50311256] $142 137%
Ascension Living Hope [503201517] $142 137%
Orscheln Industries [503201608] $152 146%
Alt Lucent Health Solutions [503202603] $156 150%
Empire Plan/Nyship [503200705] $156 150%
Alt Lineco [5032000976] $156 150%
Point Comfort Underwriters [503200018] $162 156%
Quiktrip [5032000412] $162 156%
Century Health Solutions [503200054] $162 156%
Wppa [503200056] $171 165%
Usa Managed Care [503999030] $183 176%
Three Rivers Provider Network [503999029] $183 176%
Sanford Health Plan [503999027] $183 176%
Employers Health Network [503999025] $183 176%
Plan Care America [503999026] $183 176%
Workers Comp [503999901] $193 186%

Consumer Guidance & Cost Commentary

For this procedure, the University of Kansas Hospital's cash price of $41.00 is significantly lower than the facility's gross charge of $203.00 and the Medicare benchmark of $103.79. While the hospital is a government-owned acute care facility in Kansas City, KS, patients with high-deductible plans may find the cash rate more affordable than the negotiated rates paid by insurance carriers, which range from $60 to $183 depending on the payer. Although the facility's cash price is lower than the state average, it is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures. Patients should verify their specific plan's allowed amount before scheduling, as some in-network rates may still be higher than the self-pay option.

To ensure you receive the most accurate billing, we recommend requesting an itemized bill that details every CPT code and service rendered, as summary bills can sometimes obscure errors or unbundled charges. If you receive a balance bill for the difference between the provider's full charge and your insurance payment, you may be protected under the No Surprises Act if the service was provided at an in-network facility or was an emergency situation. Additionally, ask the hospital about prompt-pay discounts, which can reduce the cash price further by 20% to 50% if paid upfront, bypassing the administrative fees associated with insurance claims processing. Always dispute any unexpected bills in writing before accepting them to protect your financial interests.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4000 Cambridge Street, Kansas City, KS 66160
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals