CMS Price Transparency Data

Group therapy session

Facility: Ochsner St Anne General Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $73
Cash Discount Price: $38
vs. Medicare Baseline: 0.70x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Ochsner St Anne General Hospital is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.70x the Medicare baseline. Located in 4608 Highway 1, Raceland, LA.

Cash / Self-Pay

$38

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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: $38 (37%)

Insurance Median: $73 (70%)

Cash: $38 (37% of Medicare)

Ins. Median: $73 (70% 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
Tricare	$24 - $27	23%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$27	26%
Blue Cross Blue Shield	$27 - $392	26%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$27	26%
Humana	$27	26%
Medicare (plans)	$27	26%
Ochsner Health Plan	$27	26%
UnitedHealthcare	$27 - $265	26%
Healthcomp & Personify Health (Formerly Gilsbar)	$64	62%
Louisiana Workers' Compensation Corporation (Lwcc)	$64	62%
Mississippi Physicians Care Network	$64	62%
Medicaid / KanCare	$66	64%
Employers Health Network (Ehn)	$73	70%
First Health Network	$73	70%
Prime Health Services Ppo	$73	70%
Claritev D/B/A Multiplan/Phcs/American Life Care	$77	74%
Usa Managed Care Network	$77	74%
Zelis	$77	74%
Aetna	$79	76%
Cigna	$82	79%

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 $38.
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 Ochsner St Anne General 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.