CMS Price Transparency Data

Group therapy session

Facility: Wyandotte Hospital and Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $28
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Wyandotte Hospital and Medical Center is $28. 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 0.27x the Medicare baseline. Located in 2333 Biddle Ave, Wyandotte, MI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$28

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: $28 (27%)

Ins. Median: $28 (27% 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
Aetna	$13 - $100	13%
Hap	$13 - $91	13%
Mclaren	$13	13%
Meridian Health Plan Of Mi	$13 - $109	13%
Priority Health	$13 - $162	13%
Blue Cross Blue Shield	$15 - $91	14%
Amerihealth Michigan	$16 - $89	15%
Hap Caresource	$16 - $91	15%
Mclaren Health Plan Inc.	$16 - $29	15%
Meridian	$16 - $29	15%
Humana	$17 - $92	16%
Molina	$17 - $122	16%
Priority	$17 - $29	16%
Pace Se Mi	$24 - $27	23%
Bcn	$25 - $91	24%
Cca Health Mi	$25 - $29	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 Ma	$25	24%
Vaccn	$26 - $31	25%
Beacon Health	$29 - $83	28%
Vitalcore Physicians Group Of Mi	$32 - $208	31%
Cigna	$35 - $72	34%
Cofinity	$47	45%
Cofinity Group Health	$73	70%
Pace Of Se Mi	$86	83%
Cca Health Michigan	$91	88%
Erickson	$91	88%
Mclaren Health	$91	88%
Molina Mi Health Link	$91	88%
Wellcare	$92	89%

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 Wyandotte Hospital and Medical Center 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.