Group therapy session
Facility: Amberwell Atchison Association
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $112
- Cash Discount Price: $218
- vs. Medicare Baseline: 1.08x 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 |
|---|---|---|
| Blue Cross Blue Shield | $28 - $30 | 27% |
| Superior Select Mcr Adv - All Plans | $72 | 69% |
| Humana | $72 - $98 | 69% |
| Triwest - All Plans | $72 | 69% |
| UnitedHealthcare | $72 - $391 | 69% |
| Va Ccn - All Plans | $72 | 69% |
| Ambetter / Centene | $112 | 108% |
| Cigna | $120 | 116% |
| Aetna | $120 | 116% |
| Centrus Health Direct - All Plans | $164 | 158% |
| Oscar - All Plans | $164 | 158% |
| Multiplan - All Plans | $170 | 164% |
| Wppa Providrs Care - All Plans | $196 | 189% |
Consumer Guidance & Cost Commentary
For the CPT code 90853, representing a group therapy session at Amberwell Atchison Association in Atchison, Kansas, the cash price is $218.00. This cash rate is identical to the facility's median negotiated rate of $116.00, which is significantly lower than the gross charge of $218.00. While the facility is a Critical Access Hospital in a Voluntary non-profit - Private ownership structure, the data does not provide specific county or state average comparisons to contextualize this pricing. However, it is important to note that for patients with high-deductible plans, paying the cash price of $218.00 upfront can sometimes be more cost-effective than relying on insurance, as the negotiated rates paid by insurers often exceed the cash price due to administrative overheads included in the billing cycle.
Patients should be aware that while the facility offers a cash price of $218.00, the median amount paid by insurance payers varies widely, ranging from $28 to $391 depending on the specific plan. For instance, Blue Cross Blue Shield plans pay a low of $28 to $30, while UnitedHealthcare plans can pay as high as $391. To minimize costs, consumers are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which may offer a fee reduction of 20% to 50% for upfront payment. Additionally, if a patient has out-of-network coverage or receives services from ancillary providers not contracted with their insurer, they may face balance billing for the difference between the allowed amount and the full charg