CMS Price Transparency Data

Group therapy session

Facility: Rockcastle County Hospital, Inc.

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $40
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 0.39x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Rockcastle County Hospital, Inc. is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.39x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$103.79

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $103.79 (100%)
Cash / Self-Pay: $35 (34%)
Insurance Median: $40 (39%)
Cash: $35 (34% of Medicare)
Ins. Median: $40 (39% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Passport Hp Hmo - All Plans $12 12%
Caresource Mcaid $19 18%
Coventry Mcaid-All Plans $19 18%
Medicaid / KanCare $19 18%
Molina Mcaid $19 18%
UnitedHealthcare $19 - $350 18%
Blue Cross Blue Shield $31 - $95 30%
Multiplan-All Plans $39 38%
Prime Health Services-All Plans $39 38%
Corvel - All Plans $41 40%
Integrated Hp-All Plans $41 40%
Center Care-All Plans $44 42%
Cigna $45 43%
Tricare $71 68%
Caresource Mcr Adv-All Other Plans $95 92%
Humana $95 - $322 92%
Molina Marketplace - All Other Plans $95 92%
Molina Mcr Adv $95 92%
Signature Mcr Adv-All Plans $95 92%
Wellcare Mcr Adv-All Other Plans $95 92%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals