CMS Price Transparency Data

Group therapy session

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $91
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Ascension Providence Hospital, Southfield and Novi is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.88x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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%)

Insurance Median: $91 (88%)

Ins. Median: $91 (88% 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
Molina Health	$37 - $53	36%
Hap Alliance Health	$43	41%
Hap Hmo Pos	$43	41%
Hap Preferred	$51	49%
Blue Caid Michigan	$53	51%
Harbor Health Mcd	$53	51%
Medicaid / KanCare	$53 - $91	51%
Total Health Care	$53	51%
UnitedHealthcare	$53	51%
Amerihealth Vip Care Mcr	$78 - $90	75%
Aetna	$91	88%
Auto Insurance	$91	88%
Jvhl - Mcr Replacement	$91	88%
Mcr Replacement	$91	88%
Veterans Choice	$91	88%
Humana	$92	89%
Meridian Wellcare	$95	92%
Molina Advantage	$95	92%
Ambetter / Centene	$113	109%
Molina Marketplace	$113	109%
Smart Health	$125	120%
Bc Metro Detroit Epo	$13,613 - $53,198	13116%
Bc Metro Detroit Hmo	$13,613 - $53,198	13116%
Bcn Local Network Southeast	$13,613 - $53,198	13116%
Blue Care Network	$13,613 - $53,198	13116%
Blue Cross Blue Shield	$13,613 - $53,198	13116%

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 $X.
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 Ascension Providence Hospital, Southfield and Novi 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.