Group therapy session
Facility: Satanta District Hospital, Clinics, & Ltcu
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $61
- Cash Discount Price: $144
- vs. Medicare Baseline: 0.59x 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 |
|---|---|---|
| Direct Benefit-All Plans | $14 - $63 | 13% |
| UnitedHealthcare | $17 - $263 | 16% |
| Berkley Net-All Plans | $23 - $105 | 22% |
| Meritain Health-All Plans | $26 - $118 | 25% |
| Trustmark Health Benefits-All Plans | $26 - $116 | 25% |
| Aetna | $26 - $179 | 25% |
| Ambetter / Centene | $28 - $126 | 27% |
| Pinnacol-All Plans | $32 - $147 | 31% |
| Axa Equitable - All Plans | $32 - $145 | 31% |
| Medi-Share-All Plans | $33 - $150 | 32% |
| Presbyterian-All Plans | $35 - $160 | 34% |
| Kasb Work Comp - All Plans | $37 - $168 | 36% |
| The Kempton Group Admin-All Plans | $40 - $181 | 39% |
| Auxiant - All Plans | $41 - $184 | 40% |
| Gpha(Wppa)-All Other Plans | $41 - $184 | 40% |
| Wppa- All Plans | $41 - $187 | 40% |
| Providers Care Network- All Plans | $42 - $189 | 40% |
| Sisco-All Plans | $42 - $189 | 40% |
| Gpha Employee Benefit Plan | $42 - $192 | 40% |
| Emc-All Plans | $42 - $189 | 40% |
| Regional Care(Wppa)-All Plans | $44 - $197 | 42% |
| First Health -All Plans | $44 - $200 | 42% |
| Triangle-All Plans | $44 - $200 | 42% |
| Employee Benefit-All Plans | $44 - $197 | 42% |
| One Call Physician-All Plans | $45 - $203 | 43% |
| Tricare | $46 - $210 | 44% |
| Christian Hospital Aid - All Plans | $46 - $210 | 44% |
| Blue Cross Blue Shield | $46 - $208 | 44% |
| Humana | $50 - $226 | 48% |
| Cigna | $51 - $231 | 49% |
| Luminare Health- All Plans | $51 - $231 | 49% |
| Deseret Mutual(Uhis)-All Plans | $52 - $237 | 50% |
| Coresource-All Plans | $52 - $237 | 50% |
| Vaccn-All Plans | $53 - $242 | 51% |
| Reserve National-All Plans | $55 - $250 | 53% |
| Wps Vapc-All Plans | $55 - $250 | 53% |
| Hma Llc-All Plans | $55 - $250 | 53% |
| Medicaid / KanCare | $58 - $263 | 56% |
Consumer Guidance & Cost Commentary
For this group therapy session (CPT 90853) at Satanta District Hospital in Kansas, the facility's cash price of $144.00 is notably lower than the state average for this service, which ranges from $14 to $263 across 38 different payers. While the facility's negotiated rates with insurance plans vary widely—starting at $14 for some Direct Benefit plans and reaching up to $263 for Medicaid/KanCare—the cash price often provides a more predictable cost for patients with high-deductible plans or those without coverage. It is important to note that commercial insurance negotiated rates frequently include administrative overhead and do not reflect the actual cost of care, which is why comparing these rates to the Medicare benchmark of $103.79 reveals the true baseline for pricing.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services are billed separately. To ensure you receive the most accurate pricing, always request a full itemized bill before paying, as summary bills may obscure errors or unbundled charges. Additionally, since the facility offers prompt-pay discounts for upfront payment, you should explicitly ask to be classified as a self-pay patient prior to scheduling your visit to secure the best possible rate and avoid unnecessary administrative fees.