CMS Price Transparency Data

Group therapy session

Facility: Boston Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $72
Cash Discount Price: $64
vs. Medicare Baseline: 0.69x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Boston Medical Center is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.69x the Medicare baseline. Located in 1 Boston Medical Center Place, Boston, MA.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

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: $64 (62%)

Insurance Median: $72 (69%)

Cash: $64 (62% of Medicare)

Ins. Median: $72 (69% 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
Tufts [8002]	$16 - $18	15%
Cigna	$18 - $122	17%
Medicaid / KanCare	$51	49%
Uphams Corner Esp [1213]	$57	55%
Workers Comp [5002]	$61	59%
Zzzbu Employee Work Comp [5004]	$61	59%
Zzzcity Of Boston Work Comp [5003]	$61	59%
Aetna	$70	67%
Meritain Health [1023]	$70	67%
Harvard Pilgrim Health Care [8001]	$72	69%
Health Plans Inc [2027]	$72	69%
United [2025]	$72	69%
Zzzhealth Plans Inc [1013]	$72	69%
Zzzunited [1008]	$72	69%
Mass General Brigham Health Plan Commercial [8009]	$77	74%
Champva [9004]	$104	100%
Tricare	$104	100%
Unicare [8004]	$107	103%
Wellpoint [2034]	$107	103%
Blue Cross Blue Shield	$156	150%
Tufts Conncare/Qhp [8020]	$431	415%
Hsn Bad Debt [4003]	$513	494%
Hsn Confidential [4007]	$513	494%
Hsn Dental [4006]	$513	494%
Hsn Partial [4002]	$513	494%
Hsn [4001]	$513	494%

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 $64.
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 Boston 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.