CMS Price Transparency Data

Group therapy session

Facility: Sanford Bagley Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $1,491
Cash Discount Price: $1,400
vs. Medicare Baseline: 14.37x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Sanford Bagley Medical Center is $1,491. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,400. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 14.37x the Medicare baseline. Located in 203 4Th Street Northwest, Bagley, MN.

Cash / Self-Pay

$1,400

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,491

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: $1,400 (1349%)

Insurance Median: $1,491 (1437%)

Cash: $1,400 (1349% of Medicare)

Ins. Median: $1,491 (1437% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1437% of the Medicare baseline (a markup of 1337%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Ucare	$97 - $1,538	93%
Blue Cross Blue Shield	$424 - $1,619	409%
Sanford Health Plan Align	$798	769%
Health Partners	$864 - $1,418	832%
Medicare (plans)	$864	832%
UnitedHealthcare	$864 - $1,461	832%
Primewest	$882 - $943	850%
Aetna	$938 - $1,521	904%
Security Health Plan	$962	927%
Sanford Health Plan	$1,381 - $1,625	1331%
Medica	$1,538 - $1,656	1482%
Cigna	$1,575	1517%
First Choice Health Network	$1,575	1517%
Healthez	$1,575	1517%
Multiplan	$1,575	1517%

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 $1,400.
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 Sanford Bagley 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.