Group therapy session
Facility: Via Christi Hospital Wichita St Teresa, Inc
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $86
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.83x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $76 | 73% |
| Saint Lukes Health Systems | $86 | 83% |
| Vc Hope | $86 | 83% |
| Medicare (plans) | $86 - $87 | 83% |
| Va | $86 | 83% |
| Via Christi Research | $86 | 83% |
| Humana | $86 | 83% |
| Blue Cross Blue Shield | $87 | 84% |
| UnitedHealthcare | $87 - $240 | 84% |
| Corizon | $107 | 103% |
| Smarthealth | $120 | 116% |
| Medicaid / KanCare | $145 | 140% |
Consumer Guidance & Cost Commentary
For the CPT code 90853, representing a group therapy session at Via Christi Hospital Wichita St Teresa, Inc, the negotiated rates across 12 payers range from $76 to $240, with a median negotiated amount of $86.00. This facility is a voluntary non-profit church-owned acute care hospital located in Wichita, Kansas (ZIP 67235). While specific cash or median paid values are not reported for this service, patients should be aware that cash-pay options can sometimes be more cost-effective than insurance negotiated rates, particularly for those with high-deductible plans where the insurer's allowed amount exceeds the cash price. It is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can significantly reduce the final bill by bypassing administrative processing fees and insurance claim cycles.
Pricing transparency for this service relies on Medicare benchmarking, where the Medicare amount of $103.79 serves as the objective baseline for evaluating commercial rates. Commercial negotiated rates often exceed this benchmark due to administrative structures and contract dynamics, though fair pricing is typically defined as 120% to 150% of the Medicare rate. Consumers should avoid using the hospital's inflated chargemaster list as a benchmark, as savings are often calculated against these high list prices rather than the true cost of care. If a patient receives a bill that includes unexpected charges from out-of-network providers, such as emergency physicians or lab services, they may be eligible for protections under the No Surprises Act, which bans balance billing for non-emergency services at in-network facilities. To ensure accuracy, patients should request a full itemized CPT-coded bill before paying