CMS Price Transparency Data

Group therapy session

Facility: Memorial Mission Hospital and Asheville Surgery Ce

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $192
Cash Discount Price: $518
vs. Medicare Baseline: 1.85x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Memorial Mission Hospital and Asheville Surgery Ce is $192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $518. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.85x the Medicare baseline. Located in 509 Biltmore Ave, Asheville, NC.

Cash / Self-Pay

$518

Average discount available for prompt cash payment at this facility.

Insurance Median

$192

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: $518 (499%)

Insurance Median: $192 (185%)

Cash: $518 (499% of Medicare)

Ins. Median: $192 (185% 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	$95 - $204	92%
United	$97 - $306	93%
Wellcare	$98	94%
Amerihealth	$99	95%
Partners Health Management	$100	96%
Vaya Health	$100	96%
Apex Health	$104	100%
Oscar	$185	178%
Aetna	$188 - $375	181%
Cigna	$192 - $258	185%
Medcost	$226 - $441	218%
Caresource	$228	220%
Amerihealth Caritas	$244 - $396	235%
Multiplan	$415	400%
Avalon Administrative Services	$441	425%
Prime Health	$456 - $467	439%

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 $518.
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 Memorial Mission Hospital and Asheville Surgery Ce 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.