CMS Price Transparency Data

Group therapy session

Facility: Mercy Regional Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $360
Cash Discount Price: $108
vs. Medicare Baseline: 3.47x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Mercy Regional Medical Center is $360. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 3.47x the Medicare baseline. Located in 800 E Main, Ville Platte, LA.

Cash / Self-Pay

$108

Average discount available for prompt cash payment at this facility.

Insurance Median

$360

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: $108 (104%)

Insurance Median: $360 (347%)

Cash: $108 (104% of Medicare)

Ins. Median: $360 (347% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 347% of the Medicare baseline (a markup of 247%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$43	41%
Mcd Hmo Amerigroup	$43	41%
Mcd Hmo La Care	$43	41%
Mcd Hmo La Hlth Cr Connct	$43	41%
Medicaid / KanCare	$43 - $360	41%
UnitedHealthcare	$44	42%
Mcd Hmo Com Hlth Solution	$48	46%
Charity/Map	$108 - $360	104%
Blue Cross Blue Shield	$151	145%
Pp0/Manged Care	$180 - $360	173%
Ppo/Manged Care	$180 - $360	173%
American Postal Workers	$288	277%
Work Comp	$324	312%
Commerical	$360	347%
Commerical Ip	$360	347%
Mcr American Hlth Adv	$360	347%
Medicare (plans)	$360	347%
Mra Auto/Liability	$360	347%
Tricare	$360	347%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $108.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90853.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90853.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.