CMS Price Transparency Data

Group therapy session

Facility: Emerson Hospital -

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $120
Cash Discount Price: $133
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Emerson Hospital - is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $133. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.16x the Medicare baseline. Located in 133 Old Road To 9 Acre Corner, W Concord, MA.

Cash / Self-Pay

$133

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

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: $133 (128%)

Insurance Median: $120 (116%)

Cash: $133 (128% of Medicare)

Ins. Median: $120 (116% 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
Masshealth	$105	101%
Mgb Mh Aco	$105	101%
Tufts Ppo	$105	101%
Aetna	$113	109%
Blue Cross Blue Shield	$114 - $125	110%
Medicare (plans)	$119 - $122	115%
Tufts Senior Care Options	$119	115%
UnitedHealthcare	$120 - $177	116%
Medicaid / KanCare	$122	118%
Wellpoint (Formerly Unicare)	$133	128%
Cigna	$162	156%

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 $133.
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 Emerson 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.