CMS Price Transparency Data

Group therapy session

Facility: Christian Hospital Northeast

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $343
Cash Discount Price: $317
vs. Medicare Baseline: 3.30x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Christian Hospital Northeast is $343. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $317. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 3.30x the Medicare baseline. Located in 11133 Dunn Road, Saint Louis, MO.

Cash / Self-Pay

$317

Average discount available for prompt cash payment at this facility.

Insurance Median

$343

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: $317 (305%)

Insurance Median: $343 (330%)

Cash: $317 (305% of Medicare)

Ins. Median: $343 (330% 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 330% of the Medicare baseline (a markup of 230%). 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
Healthscope Benefits [258]	$238	229%
UnitedHealthcare	$238 - $392	229%
Healthlink [225]	$256 - $399	247%
Mercy Behavioral Health [573]	$258	249%
Cigna	$278 - $422	268%
Aetna	$285 - $396	275%
Allied Benefits [498]	$285 - $392	275%
Consociate [478]	$285	275%
Coresource [497]	$285	275%
Fmh Benefit Service Inc [222]	$285	275%
Mail Handlers [495]	$285	275%
Sarah Bush Lincoln [636]	$285	275%
Blue Cross Blue Shield	$290 - $459	279%
Cox Health Systems Insurance Company [220]	$290 - $343	279%
Health Alliance [224]	$290	279%
Humana	$294	283%
Medicare (plans)	$299	288%
Mh Net [273]	$299	288%
Apwu Health Plan [216]	$301	290%
Nalc Health Benefit Plan [242]	$301	290%
Priority Health [648]	$301	290%
Hope Trust [806]	$306	295%
Med-Pay [480]	$343 - $396	330%
Unicare [568]	$343 - $399	330%
First Health Commercial [734]	$392	378%
Beechstreet [551]	$396	382%
Detego Health [868]	$396	382%
Health Systems Inc [620]	$396	382%
Healthcare Sol Mercy [609]	$396	382%
Multiplan Commercial [737]	$396	382%
Multiplan [240]	$396	382%
Phcs [244]	$396 - $422	382%
Preferred Health Professionals [561]	$399	384%
Hfn [563]	$422	407%
Medica [661]	$422	407%

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 $317.
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 Christian Hospital Northeast 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.