CMS Price Transparency Data

Group therapy session

Facility: Holland Community Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $49
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 0.47x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Holland Community Hospital is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.47x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $36 (35%)
Insurance Median: $49 (47%)
Cash: $36 (35% of Medicare)
Ins. Median: $49 (47% 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
Molina Mcaid - All Plans $16 - $96 15%
Ph Mcaid $16 - $96 15%
Meridian Mcaid Profee Only-All Plans $19 18%
UnitedHealthcare $19 - $50 18%
Benefit Source Inc-All Plans $20 - $270 19%
Life Circles-All Plans $23 - $96 22%
Health Alliance Mcr Adv $24 - $101 23%
Ph Mcr Adv $24 - $101 23%
Va Ccn - All Plans $24 - $101 23%
Aetna $25 - $240 24%
Longevity Health Plan-All Plans $26 - $109 25%
Nomi Health - All Plans $27 - $165 26%
Sisco Epi $27 26%
Sisco-All Other Plans $27 - $42 26%
Blue Cross Blue Shield $32 - $33 31%
First Health-All Plans $32 - $270 31%
Cigna $33 - $130 32%
Priority Health - All Other Plans $33 - $144 32%
Blue Care Network - All Plans $34 - $225 33%
Cofinity -All Plans $34 - $210 33%
Asr - All Plans $43 - $240 41%
Health Alliance Ahl - All Other Plans $43 - $240 41%
Health Alliance Hmo $43 - $229 41%
Multiplan - All Plans $43 - $261 41%
Usa Managed Care-All Plans $44 - $270 42%
Lifesynch Bh Comm - All Other Plans $45 - $120 43%
Lifesynch Bh Mcr $45 - $120 43%
Integrated Health Plans-All Plans $47 - $285 45%
United Behav Hlth Mcr $264 254%
United Behav Hlth - All Other Plans $301 290%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 602 Michigan Ave, Holland, MI 49423
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals