Group therapy session
Facility: Bob Wilson Memorial Hospital
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $40
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.39x 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 | $40 | 39% |
Consumer Guidance & Cost Commentary
For this CPT code representing a group therapy session at Bob Wilson Memorial Hospital in Ulysses, Kansas, the negotiated rate is $40.00, which aligns exactly with the lowest and highest reported values from the single payer, Blue Cross Blue Shield. This facility, a Critical Access Hospital owned by a voluntary non-profit church, does not have available cash or median paid data in the current report. While commercial negotiated rates often include administrative overhead that can inflate prices, patients with high-deductible plans should consider that paying cash directly might be more cost-effective if the insurance negotiated rate exceeds the facility's cash price, though no cash price is currently listed for this service.
To ensure you are not overcharged, it is important to understand that hospitals often issue summary bills that obscure individual line items, making it difficult to spot errors or unbundled charges. If you receive a bill for this service, you should request a full itemized audit to verify that every charge corresponds to a specific CPT code and that no services were rendered but billed. Additionally, since prompt-pay discounts are commonly offered to patients who settle their balance upfront, you should contact the hospital directly to inquire about self-pay or prompt-pay rates before scheduling your appointment, as these discounts can significantly reduce the final amount owed compared to the standard negotiated rate.