CMS Price Transparency Data

Group therapy session

Facility: Cox Medical Centers

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $101
Cash Discount Price: $51
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Cox Medical Centers is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.97x the Medicare baseline. Located in 3801 South National Avenue, Springfield, MO.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $51 (49%)

Insurance Median: $101 (97%)

Cash: $51 (49% of Medicare)

Ins. Median: $101 (97% 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
Parkcrest Dental Group	$71	68%
Coastal Energy Corporation	$72	69%
Heart Of America Beverage Company	$73	70%
Loren Cook	$75	72%
Springfieldgreene Co Library	$76	73%
Src Holdings Corporation	$77	74%
Ozark Anesthesia Assoc. Inc	$78	75%
Justice Furniture And Bedding Co	$80	77%
Missouri Affiliated School Consortium (Masc)	$80	77%
The Durham Company	$80	77%
Ozark County	$81	78%
Ozarks Cocacola	$82	79%
Flora Farms	$83	80%
Advanced Concrete Technology	$84	81%
Cox Healthplans	$101	97%
Health Net Federal Services	$101	97%
Humana	$101 - $230	97%
Medrisk Llc	$101	97%
UnitedHealthcare	$101	97%
Blue Cross Blue Shield	$103	99%
Allwell	$104	100%
Devoted	$108	104%
Provider Partners Health Plan	$108	104%
United Behavioral Health	$108	104%
Compsych	$135	130%
Texas Co Memorial Hospital	$149	144%
Bjc Health Solutions	$161	155%
Aps Healthcare	$240	231%
E4 Health Inc	$250	241%
Magellan	$250	241%
Interface Eap	$267	257%
Cigna	$299	288%
Mercy Managed	$380	366%

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 $51.
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 Cox Medical Centers 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.