CMS Price Transparency Data

Group therapy session

Facility: Lake Charles Memorial Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $69
  • Cash Discount Price: $106
  • vs. Medicare Baseline: 0.66x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Lake Charles Memorial Hospital is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.66x the Medicare baseline. Located in 1701 Oak Park Blvd, Lake Charles, LA.
Cash / Self-Pay
$106

Average discount available for prompt cash payment at this facility.

Insurance Median
$69

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: $106 (102%)
Insurance Median: $69 (66%)
Cash: $106 (102% of Medicare)
Ins. Median: $69 (66% 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
Meritain $36 - $123 35%
Verity $38 - $132 37%
Ppo_Plus_ $47 - $164 45%
Phcs $55 - $192 53%
United_Healthcare $55 - $192 53%
United_Healthcare_Behavorial_Health $55 - $192 53%
Cigna $59 - $206 57%
Lwcc $60 - $210 58%
First_Health $63 - $219 61%
Aetna $69 - $244 66%
Blue Cross Blue Shield $69 66%
Champus_Va $69 66%
Medicare (plans) $69 66%
Tricare $69 66%
Veterans_Administration $69 66%
Veterans_Choice-Triwest $69 66%
Humana $70 - $241 67%
Workers_Compensation $71 - $247 68%
Coushatta_Tribe_Dept_Of_Health $124 119%
Blue_Cross_Blue_Shield_La $147 142%
Vantage_Commercial $159 153%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Oak Park Blvd, Lake Charles, LA 70601
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals