CMS Price Transparency Data
Group therapy session
Facility: Mercy Hospital - Cassville
Billing Code: 90853 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90853
- Insurance Median: $367
- Cash Discount Price: $417
- vs. Medicare Baseline: 3.54x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Mercy Hospital - Cassville is $367. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $417. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 3.54x the Medicare baseline. Located in 94 Main Street, Cassville, MO.
Cash / Self-Pay
$417
Average discount available for prompt cash payment at this facility.
Insurance Median
$367
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: $417 (402%)
Insurance Median: $367 (354%)
Cash: $417 (402% of Medicare)
Ins. Median: $367 (354% 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 354% of the Medicare baseline (a markup of 254%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $25 - $780 | 24% |
| Humana | $25 - $745 | 24% |
| Medicaid / KanCare | $25 - $456 | 24% |
| Blue Cross Blue Shield | $87 - $850 | 84% |
| UnitedHealthcare | $121 - $832 | 117% |
| Dept Of Veteran Affairs Contracted [320106] | $139 - $299 | 134% |
| Tricare | $165 - $355 | 159% |
| Cherokee Nation Health Serv Contracted [320066] | $168 - $361 | 162% |
| Cigna | $168 - $832 | 162% |
| Cross Timbers Hospice [20098] | $168 - $361 | 162% |
| Elara Caring Aspire Hospice [20433] | $168 - $361 | 162% |
| Globalhealth Contracted [320145] | $168 - $361 | 162% |
| Halo Hcr Inc Hospice Contracted [320432] | $168 - $361 | 162% |
| Halo Hcr Inc Hospice [20432] | $168 - $361 | 162% |
| Indian Health Service Contracted [320198] | $168 - $361 | 162% |
| Kindful Hospice Contracted [320434] | $168 - $361 | 162% |
| Kindful Hospice [20434] | $168 - $361 | 162% |
| Medical Associates Health Contracted [320444] | $168 - $361 | 162% |
| Medicare (plans) | $168 - $375 | 162% |
| Mercy Hospice Okc [20252] | $168 - $361 | 162% |
| Mercy Mgd Behavioral Health Contracted [320259] | $168 - $361 | 162% |
| Pace Of The Ozarks Contracted [320518] | $168 - $361 | 162% |
| Provider Partners Health Plans Contracted [320450] | $168 - $361 | 162% |
| Qual Choice Contracted [320325] | $168 - $361 | 162% |
| Healthscope Contracted [320182] | $171 - $366 | 165% |
| Administrative Payor Contracted [320005] | $184 - $394 | 177% |
| Centivo Contracted [320505] | $208 - $447 | 200% |
| Ambetter / Centene | $212 - $456 | 204% |
| Home State Health Plan Contracted [320187] | $212 - $456 | 204% |
| Novasys Contracted [320285] | $212 - $456 | 204% |
| Healthlink Contracted [320179] | $265 - $788 | 255% |
| Preferred Health Plan Contracted [320522] | $265 - $569 | 255% |
| Health Systems Inc Contracted [320174] | $326 - $701 | 314% |
| Insurance System Inc Contracted [320465] | $326 - $701 | 314% |
| Point C Contracted [320238] | $326 - $788 | 314% |
| Point C [20238] | $326 - $701 | 314% |
| United Medical Resources Contracted [320454] | $326 - $745 | 314% |
| Workers Comp [20426] | $326 - $788 | 314% |
| Municipal Health Plan Contracted [320271] | $330 - $710 | 318% |
| Medica Contracted [320239] | $366 - $785 | 353% |
| 90 Degree Benefits Contracted [320436] | $367 - $788 | 354% |
| Aither Health Contracted [320449] | $367 - $788 | 354% |
| American Healthcare Alliance Contracted [320020] | $367 - $788 | 354% |
| Auxiant Contracted [320462] | $367 - $788 | 354% |
| Benefit Management Contracted [320052] | $367 - $788 | 354% |
| Ebms Contracted [320493] | $367 - $788 | 354% |
| Edison Health Solutions Contracted [320502] | $367 - $788 | 354% |
| Evolutions Health Care Contracted [320124] | $367 - $788 | 354% |
| Imagine 360 Contracted [320494] | $367 - $788 | 354% |
| Mercy Benefit Admin Contracted [320251] | $367 - $788 | 354% |
| Reflect Health Contracted [320492] | $367 - $788 | 354% |
| Show-Me Health Administrators Contracted [320483] | $367 - $788 | 354% |
| Usa Managed Care Org Contracted [320429] | $367 - $788 | 354% |
| Yuzu Health Contracted [320521] | $367 - $788 | 354% |
| First Health Contracted [320128] | $388 - $832 | 374% |
| Multiplan Contracted [320270] | $388 - $832 | 374% |
| Private Health Care Systems Contracted [320320] | $388 - $832 | 374% |