Group therapy session
Facility: Republic County Hospital
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $575
- Cash Discount Price: $469
- vs. Medicare Baseline: 5.54x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 554% of the Medicare baseline (a markup of 454%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Rural Carriers-All Plans | $531 | 512% |
| Meritain-All Plans | $562 | 541% |
| Aetna | $562 | 541% |
| UnitedHealthcare | $575 | 554% |
| Cigna | $594 | 572% |
| Midlands Choice-All Plans | $594 | 572% |
| First Health-All Plans | $594 | 572% |
Consumer Guidance & Cost Commentary
For the June 2026 vintage, Republic County Hospital in Belleville, KS, billed $625 for a group therapy session (CPT 90853), with a Medicare benchmark of $103.79. This represents a 5.5x markup compared to the federal baseline, which is significantly higher than the typical 200% to 300% range often seen in commercial negotiations. While the facility's median negotiated rate of $575 aligns with the median paid by seven commercial payers, the cash price of $469 offers a lower alternative for patients without insurance. Because commercial rates often include administrative overhead and contract markups that exceed fair pricing benchmarks, paying cash or utilizing a prompt-pay discount can result in substantial savings, particularly for those with high-deductible plans where the insurance allowed amount may still exceed the cash price.
To ensure you are not overcharged, it is critical to request an itemized billing audit rather than accepting a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or services not rendered. Since this service is provided by a voluntary non-profit Critical Access Hospital, you should explicitly ask the billing department about self-pay or prompt-pay discounts before scheduling your visit to avoid automatic claims submission that could void any cash agreement. Additionally, given that the facility is located in a rural area with a single plan per payer, verifying your specific deductible status is essential to determine if your insurance will cover the full negotiated rate or if paying the cash price directly is the more economical choice.