CMS Price Transparency Data

Group therapy session

Facility: Novant Health Forsyth Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $197
  • Cash Discount Price: $173
  • vs. Medicare Baseline: 1.90x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Novant Health Forsyth Medical Center is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $173. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.90x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.
Cash / Self-Pay
$173

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

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: $173 (167%)
Insurance Median: $197 (190%)
Cash: $173 (167% of Medicare)
Ins. Median: $197 (190% 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.

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
Carolina Complete $53 - $54 51%
Nc Department Of Public Safety $53 - $197 51%
Amerihealth $54 - $55 52%
Blue Cross Blue Shield $54 - $209 52%
UnitedHealthcare $54 - $195 52%
Wellcare $54 - $55 52%
Humana $99 - $226 95%
Pace Of The Southern Piedmont $99 95%
Aetna $101 - $232 97%
Cigna $101 - $172 97%
Liberty Health $103 99%
Caresource North Carolina $115 - $116 111%
Atlantic Corporation Dba Atlantic Packaging $162 - $164 156%
Plotkin Health $172 - $174 166%
Amps $187 - $188 180%
Medcost $244 - $273 235%
Primary Physician Care $253 - $255 244%
Beechstreet $258 - $261 249%
Multiplan $258 - $261 249%
Phcs $258 - $261 249%
Employers Choice Network $278 - $281 268%
Three Rivers Provider Network $278 - $281 268%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Silas Creek Parkway, Winston-Salem, NC 27103
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals