CMS Price Transparency Data

Group therapy session

Facility: Bienville Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $204
Cash Discount Price: $227
vs. Medicare Baseline: 1.97x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Bienville Medical Center is $204. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $227. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.97x the Medicare baseline. Located in 1175 Pine Street, Arcadia, LA.

Cash / Self-Pay

$227

Average discount available for prompt cash payment at this facility.

Insurance Median

$204

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: $227 (219%)

Insurance Median: $204 (197%)

Cash: $227 (219% of Medicare)

Ins. Median: $204 (197% 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.

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	$22 - $378	21%
Medicaid / KanCare	$22	21%
Mmd Amerihealth Caritas	$22	21%
Mmd Healthy Blue	$22	21%
Mmd La Hlth Conn	$22	21%
Mmd Misc	$22	21%
UnitedHealthcare	$22 - $204	21%
Cashiering	$151 - $227	145%
Cigna	$189	182%
Ambetter / Centene	$204	197%
Humana	$204 - $244	197%
Mcr American Hlth Adv	$204	197%
Medicare (plans)	$204	197%
Misc Mgd Care	$204 - $378	197%
Mmc Blue Advantage	$204	197%
Mmc Misc	$204	197%
Peoples Health Mcr Adv	$204	197%
Va Health	$204	197%
Blue Cross Blue Shield	$228	220%
Wc City Of Arcadia	$341	329%
Wc House Of Raeford	$341	329%
Wc Misc	$341	329%
Wc Stonetrust	$341	329%
Aarp	$378	364%
Allegiance Health Managme	$378	364%
Amfirst	$378	364%
Apwu	$378	364%
Liberty Mutual	$378	364%
Misc Comm A-L	$378	364%
Misc Comm M-Z	$378	364%
Tricare	$378	364%

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 $227.
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 Bienville 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.