CMS Price Transparency Data

Group therapy session

Facility: Sanford Luverne Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $99
Cash Discount Price: $151
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Sanford Luverne Medical Center is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.95x the Medicare baseline. Located in 1600 N Kniss Avenue P O Box 1019, Luverne, MN.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$99

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: $151 (145%)

Insurance Median: $99 (95%)

Cash: $151 (145% of Medicare)

Ins. Median: $99 (95% 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
Blue Cross Blue Shield	$26 - $251	25%
Sanford Health Plan Align	$38 - $95	37%
Ucare	$40 - $238	39%
Aetna	$41 - $236	40%
Health Partners	$41 - $217	40%
Medicare (plans)	$41 - $103	40%
UnitedHealthcare	$41 - $226	40%
Primewest	$42 - $128	40%
Sanford Health Plan	$57 - $171	55%
Security Health Plan	$59 - $149	57%
Medica	$94 - $256	91%
Cigna	$96 - $244	92%
First Choice Health Network	$96 - $244	92%
Healthez	$96 - $244	92%
Multiplan	$96 - $244	92%

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 $151.
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 Luverne 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.