CMS Price Transparency Data

Group therapy session

Facility: Essentia Health St Joseph's Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $160
  • Cash Discount Price: $192
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Essentia Health St Joseph's Medical Center is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.54x the Medicare baseline. Located in 523 North 3Rd Street, Brainerd, MN.
Cash / Self-Pay
$192

Average discount available for prompt cash payment at this facility.

Insurance Median
$160

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: $192 (185%)
Insurance Median: $160 (154%)
Cash: $192 (185% of Medicare)
Ins. Median: $160 (154% 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
Medica Access $56 - $190 54%
Sanford Health Plan $75 - $272 72%
Healthpartners Care Pmap $76 - $259 73%
Blue Cross Blue Shield $79 - $421 76%
Blue Plus Pmap Pcc Prime $79 - $380 76%
Primewest $86 83%
Itasca Med Care $92 89%
Advocare/Security Health $99 95%
Freedom Blue Ppo $99 95%
Healthpartners Care Msho / Mcr Adv $99 95%
Imcare Msho Pcc Prime $99 95%
Imcare Msho Ref Req $99 95%
Medica Advantage Solutions $99 95%
Medica Msho/Dual Solutions $99 95%
Medica Prime Solution Group $99 95%
Medicare (plans) $99 95%
Nd Va Administration $99 95%
Platinum Blue/Vantage Blue $99 95%
Primewest Msho $99 95%
Secure Blue Msho $99 95%
Ubh Cost Plan $99 95%
Ubh Msho $99 95%
Ucare Msho $99 95%
UnitedHealthcare $99 - $458 95%
Medica $112 - $426 108%
Medica Uplan $112 - $383 108%
Ucare $116 - $396 112%
Wea $127 - $464 122%
Medica Choice $128 - $438 123%
Cigna $129 - $442 124%
Healthpartners $129 - $442 124%
Healthpartners Pcc Prime $129 - $442 124%
America'S Ppo $136 - $467 131%
Wps $146 - $506 141%
Aetna $150 - $512 145%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 523 North 3Rd Street, Brainerd, MN 56401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals