CMS Price Transparency Data

Group therapy session

Facility: Mercy Health Saint Mary's

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $36
  • Cash Discount Price: $80
  • vs. Medicare Baseline: 0.35x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Mercy Health Saint Mary's is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.35x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$80

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $80 (77%)
Insurance Median: $36 (35%)
Cash: $80 (77% of Medicare)
Ins. Median: $36 (35% 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

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $19 - $64 18%
Aetna $20 - $77 19%
Albany County Correctional Facility $20 19%
Ambetter / Centene $20 19%
Amish Mennonite $20 19%
Ascension St. Vincent Public Safety Medical $20 19%
Bccp $20 19%
Blue Cross Blue Shield $20 - $59 19%
Bmc Healthnet $20 19%
Breast Grant-Connecticut $20 19%
Broward County Dept Of Health $20 19%
California Health And Wellness $20 19%
Cardinal Innovations Lme $20 19%
Care Connections Of Northern Iowa $20 19%
Care Oregon Ohp $20 19%
Cencal Health Plan $20 19%
Cenpatico $20 19%
Champva $20 19%
Chhuny $20 19%
Childrens Comm Health Plan $20 19%
Childrens Medical Services Title 19 $20 19%
Cigna $20 - $90 19%
City Of Philadelphia $20 19%
Cmh Allegan County $20 - $123 19%
Cmh Ausable Valley $20 - $123 19%
Cmh Barry County $20 - $123 19%
Cmh Bay-Arenac County $20 19%
Cmh Berrien County $20 - $123 19%
Cmh Cass County $20 - $123 19%
Cmh Central Mi County $20 19%
Cmh Clinton-Eaton-Ingham County $20 - $123 19%
Cmh Detroit Wayne Integrated Health Network $20 19%
Cmh Genesee County $20 19%
Cmh Ionia County $20 19%
Cmh Jackson County/Lifeways $20 19%
Cmh Kalamazoo $20 - $123 19%
Cmh Kent County $20 - $123 19%
Cmh Lenawee County $20 - $123 19%
Cmh Livingston County $20 19%
Cmh Macomb $20 19%
Cmh Misc $20 - $123 19%
Cmh Monroe County $20 - $123 19%
Cmh Montcalm County $20 - $123 19%
Cmh Muskegon County $20 - $123 19%
Cmh Newaygo County $20 - $123 19%
Cmh North Country $20 - $123 19%
Cmh Northern Lakes County $20 - $123 19%
Cmh Oakland County $20 19%
Cmh Ottawa County $20 - $123 19%
Cmh Van Buren County $20 - $123 19%
Cmh Washtenaw County $20 19%
Cmh Wayne County/Carelink $20 19%
Cmh Wayne Cty/Com Liv Svcs $20 19%
Cmh West Mi County $20 - $123 19%
Community Benefit Health $20 19%
Community Care Behavorial Health $20 19%
Community Care Partners $20 19%
Community Health Choice $20 19%
Connections Csp $20 19%
County Coroner $20 19%
County Funding Generic $20 19%
Covid19 Hrsa Uninsured Testing And Treatment Fund $20 19%
Dean Wi Badgercare $20 19%
Delaware County Department Of Health $20 19%
Delaware First Health $20 19%
Delta Dental Nj $20 19%
Dph Tb Program $20 19%
Dscc $20 19%
Eastpointe Lme $20 19%
Family Health Network $20 19%
Freedom First Healthcare $20 19%
Fresno County Ccs $20 19%
Ghc Scw Wi Badgercare $20 19%
Harbor Health $20 19%
Health Safety Net $20 19%
Healthy Blue Ne $20 19%
Hennepin Health $20 19%
Humana $20 - $123 19%
Id County Ada $20 19%
Id County Canyon $20 19%
Id County Cat Fund $20 19%
Id County Other $20 19%
Id County Payette $20 19%
Idaho Dept Health And Wellfare $20 19%
Idaho Womens Health Check $20 19%
Indiana Breast Cervical Cancer $20 19%
Inland Empire Health Plan $20 19%
Intercommunity Health Ohp $20 19%
Iowa Total Care $20 19%
Jai Medical System $20 19%
Kern Family Health Plan $20 19%
Keystone First $20 19%
Keystone First Chip $20 19%
La Care Health Plan $20 19%
Lakeland Care Inc $20 19%
Managed Health Services - Indiana $20 19%
Maryland Breast & Cervical Program $20 19%
Maryland Healthy Smiles - Scion Dental $20 19%
Maryland Physicians Care $20 19%
Massachusetts Behavioral Health Partnership $20 19%
Mdwise $20 19%
Medi-Cal $20 19%
Medi-Cal Healthnet $20 19%
Medstar Dc Healthy Family $20 19%
Medstar Md Health Choice $20 19%
Mo Home State Health Plan $20 19%
Molina Centennial Care $20 19%
Nascentia Health Options $20 19%
Nebraska Total Care $20 19%
New York Cancer Services Program $20 19%
Nextlevel Health $20 19%
Oregon Screenwise $20 19%
Pace Of Southwest Michigan $20 - $29 19%
Paramount Advantage $20 19%
Parkland Community Health Plan $20 19%
Partners Behavioral Lme $20 19%
Peach State Healthplan $20 19%
Philadelphia County Funding $20 19%
Presbyterian Centennial Care $20 19%
Prestige Health Choice $20 19%
Priority Partners $20 19%
Robert F Sing Program $20 19%
Rx 340B Pass Along $20 19%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $20 19%
Rx Medi-Cal $20 19%
Rx Meridian Rx $20 19%
Ryan White Florida Mssrp $20 19%
Sandhills Center Lme $20 19%
Screening For Life $20 19%
St Joseph County Hlth Dpt $20 19%
Stephenson Cty Health $20 19%
Sunshine State Health Plan $20 19%
Superior Health $20 19%
Tenncare $20 19%
Texas Children'S Health Plan $20 19%
Tricare $20 19%
Trillium Community Ohp $20 19%
Triwest Health Alliance $20 19%
Tufts Health Public Plans $20 19%
UnitedHealthcare $20 - $123 19%
Us Family Health Plan $20 19%
Vaya Health Lme $20 19%
Veterans Eval Services $20 19%
Washtenaw Health Plan $20 19%
Wellsense Health Plan $20 19%
Wi Womens Wellness $20 19%
Align Senior Care $22 - $30 21%
Ally Align Care Adv $22 - $29 21%
American Health Advantage Of Idaho $22 - $29 21%
American Health Plan $22 - $29 21%
Aurora Special Needs $22 - $29 21%
Blue Care Network Advantage $22 - $29 21%
Blue Shield - De (Highmark) Medciare Advantage $22 - $29 21%
Care Dimensions $22 - $29 21%
Care Improvement Plus $22 - $29 21%
Care Resources Pace $22 - $29 21%
Careplus Health Plans $22 - $29 21%
Cca Senior Care Options $22 - $29 21%
Central Valley Medical Services Corp Pace $22 - $29 21%
Champion Health Plan Mcr Advantage $22 - $29 21%
Clear Spring Health $22 - $29 21%
Clover Health $22 - $29 21%
Commonwealth Care Alliance $22 - $29 21%
Community Pace At Home $22 - $29 21%
Eddy Senior Care-Pace $22 - $29 21%
Eddy Seniorcare Pace $22 - $29 21%
Elementcare $22 - $29 21%
Evercare $22 - $29 21%
Everence $22 - $29 21%
Gateway Health Plan $22 - $29 21%
Genesys Pace Of Genesee County $22 - $29 21%
Georgia Health Advantage $22 - $29 21%
Gold Advantage $22 - $29 21%
Gpa Croell Redi Mix $22 - $29 21%
Health America Advantra $22 - $29 21%
Highmark Health Options Dual Plan $22 - $29 21%
Hope Select Pace $22 - $29 21%
Horizon Nj Total Care $22 - $29 21%
Hudson Headwaters Pace $22 - $29 21%
Huron Valley Pace $22 - $29 21%
Innovative Integrated Health Community Plans $22 - $29 21%
Iowa Health Advantage $22 - $29 21%
Johns Hopkins Advantage Md $22 - $29 21%
Lasso Healthcare Msa $22 - $29 21%
Life St Marys Pace $22 - $29 21%
Lifecircles Pace $22 - $29 21%
Longevity Health Plan $22 - $29 21%
Martins Point Generations Advantage $22 - $29 21%
Mass General Brigham Mcr Adv $22 - $29 21%
Medicare (plans) $22 - $31 21%
Medipak Advantage $22 - $29 21%
Mercy Life $22 - $29 21%
Mercyone Cedar Valley $22 - $29 21%
Meridian Complete $22 - $29 21%
Michigan Complete Health $22 - $29 21%
Nascentia Health Plus $22 - $29 21%
New Centry Health Careplus $22 - $29 21%
Osu Prime Care Advantage $22 - $29 21%
Pace Cny $22 - $29 21%
Pace Iowa Immanuel Pathways $22 - $29 21%
Pace Southeast $22 - $29 21%
Pace-Trinity Health $22 - $29 21%
Peak Pace Solutions $22 - $29 21%
Perennial Advantage $22 - $29 21%
Preferred Care Partners $22 - $29 21%
Presbyterian Senior Plan $22 - $29 21%
Provider Partners Health Plan Of Illinois $22 - $29 21%
Provider Partners Health Plan Of Indiana $22 - $29 21%
Pruitthealth Premier $22 - $29 21%
Reliance Community Care Partners Care Resources Pace $22 - $29 21%
Rx Allwin $22 - $29 21%
Rx Grane Grnmedd $22 - $29 21%
Rx Retiree Rx Care $22 - $29 21%
Scan Health Plan Mcr Ipa Meritage Oon $22 - $29 21%
Secure Horizons Ma Pffs $22 - $29 21%
Serenity Pace $22 - $29 21%
Siouxland Pace $22 - $29 21%
Solis Health Plans $22 - $29 21%
Sunnyview-Pace Finance Dept $22 - $29 21%
Texan Plus $22 - $29 21%
The Health Plan $22 - $71 21%
Thome Pace $22 - $29 21%
Todays Options $22 - $29 21%
Tribute Health Plans $22 - $29 21%
Um Health Advantage $22 - $29 21%
Union Health Service $22 - $29 21%
Veterans Administration $22 - $30 21%
Welbe Health $22 - $29 21%
Wellmed $22 - $29 21%
Cca - Zing Health $24 - $27 23%
Access Health $25 - $33 24%
Longevity Ipa Of Michigan Llc Health Plan Isnp $25 - $34 24%
Asr Health Benefits $27 - $78 26%
American Postal Workers Secondary $28 - $33 27%
Blue Care Network $28 - $59 27%
1199 National Benefit Fund $30 - $90 29%
Allied National Global Care $30 - $90 29%
Asrm - Reliance Standard Life Insurance $30 - $90 29%
Christian Care Ministry $30 - $90 29%
Dean Health $30 - $90 29%
Fallon Health $30 - $90 29%
Family Life Insurance Company $30 - $90 29%
International Benefit Administrators $30 - $90 29%
Lifetime Benefit Solutions $30 - $90 29%
Manhattan Life $30 - $90 29%
Molina Marketplace $30 - $40 29%
Multiplan $30 - $90 29%
Mvp $30 - $90 29%
Oscar $30 - $40 29%
Pai $30 - $90 29%
Pan-American Life $30 - $90 29%
Phcs $30 - $90 29%
Priority Health $30 - $217 29%
Trinity Health Share $30 - $90 29%
Us Health And Life $30 - $94 29%
Wellpath $30 - $40 29%
Blue Benefit Administrators Of Massachusetts $31 - $59 30%
Blue Distinction Transplant $31 - $59 30%
Blue Shield - Ca $31 - $59 30%
Blue Shield - Id (Regence) $31 - $59 30%
Blue Shield - Ny Highmark Northeastern $31 - $59 30%
Blue Shield - Ny Highmark Western $31 - $59 30%
Blue Shield - Pa (Highmark) $31 - $59 30%
Blue Shield - Wa (Regence) $31 - $59 30%
Geha $31 - $93 30%
Partners Direct Health - Brio $32 - $43 31%
Claimdoc $35 - $46 34%
Kent County Jail $35 - $46 34%
Muskegon County Jail $35 - $46 34%
Nomi Health $35 - $69 34%
Wc Accident Fund $35 - $67 34%
Wc Advantage $35 - $67 34%
Wc Aig $35 - $67 34%
Wc Allied $35 - $67 34%
Wc Amerisure $35 - $67 34%
Wc Amtrust $35 - $67 34%
Wc Asu Risk Mgt $35 - $67 34%
Wc Berkley Admin $35 - $67 34%
Wc Broadspire $35 - $67 34%
Wc Bunch & Associates $35 - $67 34%
Wc Ccmsi $35 - $67 34%
Wc Emc Insurance Company $35 - $67 34%
Wc Esis $35 - $67 34%
Wc Fcci $35 - $67 34%
Wc Federated $35 - $67 34%
Wc Gallagher Bassett $35 - $67 34%
Wc Genex Care For Ohio $35 - $67 34%
Wc Guard Insurance Company $35 - $67 34%
Wc Hartford $35 - $67 34%
Wc Liberty Mutual $35 - $67 34%
Wc Meijers $35 - $67 34%
Wc Michigan $35 - $67 34%
Wc Mitchell Frankenmuth $35 - $67 34%
Wc Pma $35 - $67 34%
Wc Sedgwick $35 - $67 34%
Wc Sentry $35 - $67 34%
Wc Travelers $35 - $67 34%
Wc Tristar $35 - $67 34%
Wc Walmart $35 - $67 34%
Wc Zurich $35 - $67 34%
Andrie Inc $36 - $43 35%
East Greenbush Central School District $36 - $43 35%
Genex Wc $36 - $43 35%
Healthsmart Workers Comp $36 - $43 35%
Jag Source $36 - $43 35%
New York State Insurance Fund $36 - $43 35%
Njm Insurance Group $36 - $43 35%
Rx Heatlhcomp $36 - $43 35%
Rx Restat $36 - $43 35%
Rx Saif Opdp Wc $36 - $43 35%
Rx Worker'S Comp $36 - $43 35%
Wc Ace $36 - $43 35%
Wc Acs Federal Employees $36 - $43 35%
Wc Acuity $36 - $43 35%
Wc Aegis $36 - $43 35%
Wc Aims $36 - $43 35%
Wc Alaska National Ins $36 - $43 35%
Wc Align Network $36 - $43 35%
Wc Am Trust N America $36 - $43 35%
Wc American Claims Mgmt $36 - $43 35%
Wc Benetech $36 - $43 35%
Wc Broward County $36 - $43 35%
Wc California State Comp Ins $36 - $43 35%
Wc California State Ins Fund $36 - $43 35%
Wc Capitol Area Health Consortium $36 - $43 35%
Wc Chartis $36 - $43 35%
Wc Chubb $36 - $43 35%
Wc Cirma $36 - $43 35%
Wc City Of Albany $36 - $43 35%
Wc City Of Sioux City $36 - $43 35%
Wc Claims Mgmt Inc $36 - $43 35%
Wc Cna $36 - $43 35%
Wc Comp One Admin C/O Manageability $36 - $43 35%
Wc Compone Admin $36 - $43 35%
Wc Corvel $36 - $43 35%
Wc Ct Healthcare Trust $36 - $43 35%
Wc Donegal Insurance Group $36 - $43 35%
Wc Employee Mutual $36 - $43 35%
Wc Enablecomp $36 - $43 35%
Wc Encore Health Network $36 - $43 35%
Wc Erie $36 - $43 35%
Wc Evolutions $36 - $43 35%
Wc Fed Ex $36 - $43 35%
Wc Federal Black Lung $36 - $43 35%
Wc Finley Occupational Health $36 - $43 35%
Wc First Agency/Occunet $36 - $43 35%
Wc Ford Motor $36 - $43 35%
Wc Fresno Unified Emp $36 - $43 35%
Wc General Motors $36 - $43 35%
Wc Generic $36 - $43 35%
Wc Great West Casualty $36 - $43 35%
Wc Guarantee Insurance $36 - $43 35%
Wc Hab $36 - $43 35%
Wc Hastings $36 - $43 35%
Wc Health Management $36 - $43 35%
Wc Heritage Summit $36 - $43 35%
Wc Hireright $36 - $43 35%
Wc Horizon $36 - $43 35%
Wc Icw Group $36 - $43 35%
Wc Idaho State Ins Fund $36 - $43 35%
Wc Intercare Insurance $36 - $43 35%
Wc Intermountain $36 - $43 35%
Wc Johns Eastern $36 - $43 35%
Wc Kemberton $36 - $43 35%
Wc Key Ins & Benefit Solutions $36 - $43 35%
Wc Mac Risk Management $36 - $43 35%
Wc Massachusetts $36 - $43 35%
Wc Mdia $36 - $43 35%
Wc Meadowbrook Claim $36 - $43 35%
Wc Medical Administrators $36 - $43 35%
Wc Memic $36 - $43 35%
Wc Mercy Workcare $36 - $43 35%
Wc Michigan Millers Mutual $36 - $43 35%
Wc Mra $36 - $43 35%
Wc Nationwide $36 - $43 35%
Wc Nca Comp $36 - $43 35%
Wc New York $36 - $43 35%
Wc New York Special Funds $36 - $43 35%
Wc North American Rishces $36 - $43 35%
Wc Northeast Health $36 - $43 35%
Wc Notre Dame $36 - $43 35%
Wc Novanet $36 - $43 35%
Wc O'Hara Corp $36 - $43 35%
Wc Occ Health Allen $36 - $43 35%
Wc Ohio Bureau $36 - $43 35%
Wc One Call Medical $36 - $43 35%
Wc Paradigm $36 - $43 35%
Wc Peerless $36 - $43 35%
Wc Praxis Health Network $36 - $43 35%
Wc Price Chopper $36 - $43 35%
Wc Procura Management $36 - $43 35%
Wc Qualcare $36 - $43 35%
Wc Quiktrip $36 - $43 35%
Wc Reny Company $36 - $43 35%
Wc Rev Claims $36 - $43 35%
Wc Risico $36 - $43 35%
Wc Rural Mutual $36 - $43 35%
Wc Saif Oregon $36 - $43 35%
Wc Secura $36 - $43 35%
Wc Sheakley Unicomp $36 - $43 35%
Wc Smile Lodge $36 - $43 35%
Wc Society $36 - $43 35%
Wc Srs $36 - $43 35%
Wc Taconic (Mro) $36 - $43 35%
Wc Taconic Farms $36 - $43 35%
Wc Triad Group $36 - $43 35%
Wc Troy Ny $36 - $43 35%
Wc Tyson $36 - $43 35%
Wc Unified Health Services $36 - $43 35%
Wc United Heartland $36 - $43 35%
Wc Us Dept Of Labor $36 - $43 35%
Wc Velocity $36 - $43 35%
Wc West Bend $36 - $43 35%
Wc West Bend Mutual/Argent $36 - $43 35%
Wc Winnebago Industries $36 - $43 35%
Wc Yankee Trails $36 - $43 35%
Wc York Risk $36 - $43 35%
Wc Zenith $36 - $43 35%
Acclaim $37 - $94 36%
Administrative Concepts $37 - $94 36%
Allegeant $37 - $94 36%
Allied Benefit Systems $37 - $71 36%
Ameriben $37 - $94 36%
American Family $37 - $94 36%
American Healthcare Alliance $37 - $94 36%
American National $37 36%
American Republic $37 - $94 36%
Amerihealth $37 - $94 36%
Aultcare $37 - $94 36%
Automated Benefit Services $37 - $94 36%
Auxiant $37 - $94 36%
Benefit Administrative Systems,Llc $37 - $94 36%
Boon Chapman $37 - $94 36%
Cam Administrative Services $37 - $94 36%
Christian Brother Services $37 - $94 36%
Christian Brothers Holy Cross $37 - $94 36%
Claimchoice Adminstrators $37 - $71 36%
Comprehensive Benefits $37 - $94 36%
Consociate $37 - $71 36%
Continental Life Insurance $37 - $94 36%
Coventry $37 - $97 36%
Custom Benefit Administrators $37 - $94 36%
Cypress Benefit Administrators $37 - $71 36%
Employee Benefit Concepts $37 - $94 36%
Employee Benefit Management $37 - $94 36%
Enterprise Group Planning $37 - $94 36%
First Health $37 - $97 36%
Forest County Potawatomi $37 - $71 36%
Freedom Life Insurance Company $37 - $94 36%
Group Administrators $37 - $94 36%
Group Marketing Services $37 - $94 36%
Group Pension Administrators $37 - $90 36%
Guardian $37 - $94 36%
Health America $37 - $94 36%
Health Choices $37 - $94 36%
Health Smart $37 - $71 36%
Healthcare Management Admin $37 36%
Healthez $37 - $94 36%
Healthgram $37 - $71 36%
Healthscope $37 - $71 36%
Insight $37 - $94 36%
Jfp Benefit Management $37 - $94 36%
Jp Farley Corporation $37 - $94 36%
Key Benefit Administrator $37 - $94 36%
Liberty Union Life Assurance Co $37 - $94 36%
Lucent Health $37 - $94 36%
Luminare Health $37 - $94 36%
Luminare Health (Detroit) $37 - $94 36%
Magnacare $37 36%
Medben $37 - $94 36%
Medcost $37 - $94 36%
Medical Mutual $37 - $77 36%
Mutual Health Services $37 - $94 36%
Mutual Of Omaha $37 - $94 36%
Ncas $37 - $94 36%
Nippon Life Ins $37 - $94 36%
Nova $37 - $94 36%
Painters Union Insurance Fund $37 - $94 36%
Physicians Mutual $37 - $94 36%
Plumbers Local 98 Insurance Fund $37 - $94 36%
Prairie States $37 - $94 36%
Preferred One $37 - $77 36%
Primary Physician Care $37 - $94 36%
Professional Benefit Administrators $37 - $94 36%
Secureone Preferred United Plans $37 - $71 36%
Siho Insurance Services $37 36%
Sisco Benefits $37 - $71 36%
The Loomis Company $37 - $94 36%
Trustmark Small Business Benefits $37 - $71 36%
Unicare $37 - $94 36%
Unified Group Services $37 - $71 36%
Valenz $37 - $94 36%
Webtpa $37 - $71 36%
Western & Southern Financial Group $37 - $94 36%
Wps $37 - $94 36%
Hap $38 - $95 37%
Varipro $38 - $80 37%
Health Partners $40 39%
Tufts Health Plan $40 39%
Meritain $44 - $77 42%
U Of M Health Plan $46 - $94 44%
Bcn Domestic $59 57%
Kaiser Domestic $59 57%
Bcccp-Michigan $64 62%
Intercare $64 - $94 62%
Acs Benefit Services $71 68%
Caresource $80 77%
Ghc Scw $90 87%
Medi Share $90 87%
Paramount Hmo $90 87%
Magellan Behavioral Health $123 119%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Jefferson Avenue Se, Grand Rapids, MI 49503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals