CMS Price Transparency Data

Group therapy session

Facility: Henry Ford Macomb Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $29
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.28x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Henry Ford Macomb Hospital is $29. 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 0.28x the Medicare baseline. Located in 15855 Nineteen Mile Rd, Clinton Township, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $29 (28%)
Ins. Median: $29 (28% 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.

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 $13 - $100 13%
Blue Cross Blue Shield $13 - $91 13%
Hap $13 - $68 13%
Mclaren $13 13%
Meridian Health Plan Of Mi $13 - $68 13%
Priority Health $13 - $91 13%
Amerihealth Michigan $16 - $89 15%
Hap Caresource $16 - $91 15%
Mclaren Health Plan Inc. $16 - $29 15%
Meridian $16 - $29 15%
Humana $17 - $68 16%
Molina $17 - $68 16%
Priority $17 - $29 16%
Pace Se Mi $24 - $27 23%
Bcn $25 - $91 24%
Cca Health Mi $25 - $29 24%
Cofinity Group Health $25 - $50 24%
Health Alliance Plan Of Michigan $25 - $29 24%
Mount Carmel Health Plan $25 - $91 24%
United Behavioral Health, Inc. $25 - $29 24%
UnitedHealthcare $25 - $91 24%
Wellcare $25 24%
Wellcare Ma $25 24%
Vaccn $26 - $31 25%
Beacon Health $29 - $38 28%
Vitalcore Physicians Group Of Mi $32 - $208 31%
Cigna $35 - $319 34%
Mclaren Health $36 - $91 35%
Multiplan, Inc. $45 43%
University Of Michigan $54 52%
Pace Of Se Mi $86 83%
Cca Health Michigan $91 88%
Molina Mi Health Link $91 88%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15855 Nineteen Mile Rd, Clinton Township, MI 48038
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals