CMS Price Transparency Data

Group therapy session

Facility: Madison Parish Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $287
Cash Discount Price: $261
vs. Medicare Baseline: 2.77x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Madison Parish Hospital is $287. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $261. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.77x the Medicare baseline. Located in 900 Johnson Street, Tallulah, LA.

Cash / Self-Pay

$261

Average discount available for prompt cash payment at this facility.

Insurance Median

$287

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: $261 (251%)

Insurance Median: $287 (277%)

Cash: $261 (251% of Medicare)

Ins. Median: $287 (277% 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 277% of the Medicare baseline (a markup of 177%). 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
Cigna	$235	226%
Aetna	$282	272%
Medicare (plans)	$282	272%
Peoples_Health	$282	272%
Tricare	$282	272%
Dignity_Health	$287	277%
Zelis_Ppo	$287	277%
Three_Rivers_Provider_Network	$423	408%
Vantage_Commercial	$470	453%
Amerihealth	$522	503%
Humana	$522	503%
Louisana_Healthcare_Connections	$522	503%
Medicaid / KanCare	$522	503%

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 $261.
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 Madison Parish Hospital 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.