CMS Price Transparency Data

Group therapy session

Facility: Ochsner Stennis Memorial Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $66
Cash Discount Price: $163
vs. Medicare Baseline: 0.64x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Ochsner Stennis Memorial Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.64x the Medicare baseline. Located in 14365 Highway 16 West, De Kalb, MS.

Cash / Self-Pay

$163

Average discount available for prompt cash payment at this facility.

Insurance Median

$66

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: $163 (157%)

Insurance Median: $66 (64%)

Cash: $163 (157% of Medicare)

Ins. Median: $66 (64% 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
Humana	$19 - $142	18%
Medicaid / KanCare	$21 - $69	20%
Cigna	$24 - $142	23%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$24 - $143	23%
Medicare (plans)	$24 - $163	23%
UnitedHealthcare	$24 - $120	23%
Shared Health Mississippi	$25 - $149	24%
Prime Health Services Ppo	$27 - $189	26%
Ambetter / Centene	$33 - $143	32%
Blue Cross Blue Shield	$33 - $224	32%
Primewell Health Services Commercial Exchange Plan	$38 - $158	37%
Primewell Health Services – Commercial	$38 - $158	37%
Cor Vel	$43 - $105	41%
Prime Health Services Ppo -Workers Comp	$43 - $103	41%
Select Administrative Services Network	$47 - $165	45%
Aetna	$49 - $153	47%
Claritev D/B/A Multiplan/Phcs/American Life Care	$55 - $177	53%
Zelis	$67 - $177	65%

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 $163.
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 Ochsner Stennis Memorial Hospital 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.