CMS Price Transparency Data

Group therapy session

Facility: Carolinas Medical Center/Behav Health

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $93
  • Cash Discount Price: $101
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Carolinas Medical Center/Behav Health is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.90x the Medicare baseline. Located in 1000 Blythe Blvd, Charlotte, NC.
Cash / Self-Pay
$101

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $101 (97%)
Insurance Median: $93 (90%)
Cash: $101 (97% of Medicare)
Ins. Median: $93 (90% 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
Alliance $24 - $53 23%
Amerihealth Caritas $24 - $44 23%
Blue Cross Blue Shield $24 - $117 23%
Carolina Complete Health $24 - $202 23%
Cigna $24 - $343 23%
Healthy Blue $24 - $45 23%
Humana $24 - $165 23%
Partners $24 - $44 23%
Sandhills $24 - $44 23%
Trillium $24 - $47 23%
UnitedHealthcare $24 - $102 23%
Vaya $24 - $45 23%
Wellcare $24 - $45 23%
Aetna $25 - $147 24%
Ortho Carolina $30 - $116 29%
Molina $48 - $53 46%
Ambetter / Centene $59 - $95 57%
Choicecare $61 - $149 59%
Medcost $62 - $119 60%
Employers Health Network $89 86%
Physician Reach Out $101 97%
Magellan $121 - $367 117%
Gmmi $131 126%
Quik Trip $131 126%
Carolina Behavioral Health $145 - $394 140%
First Health $161 - $177 155%
Healthgram $161 155%
Private Health Care Systems $161 - $165 155%
Provider Select $163 - $181 157%
Lifesynch Community Choice Care $165 159%
Beechstreet $175 - $177 169%
Multiplan $181 174%
United $310 299%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Blythe Blvd, Charlotte, NC 28203
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals