CMS Price Transparency Data

Group therapy session

Facility: Stanly Regional Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $97
  • Cash Discount Price: $101
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Stanly Regional Medical Center is $97. 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 0.93x the Medicare baseline. Located in 301 Yadkin St, Albemarle, NC.
Cash / Self-Pay
$101

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $97 (93%)
Cash: $101 (97% of Medicare)
Ins. Median: $97 (93% 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 - $25 23%
Amerihealth Caritas $24 - $25 23%
Carolina Complete Health $24 23%
Cigna $24 - $343 23%
Healthy Blue $24 23%
Humana $24 - $90 23%
Partners $24 23%
Trillium $24 - $25 23%
UnitedHealthcare $24 - $136 23%
Vaya $24 - $25 23%
Wellcare $24 23%
Aetna $25 - $181 24%
Choicecare $61 - $189 59%
Ambetter / Centene $62 - $75 60%
Blue Cross Blue Shield $75 - $104 72%
Employers Health Network $89 - $116 86%
Physician Reach Out $101 97%
Magellan $121 - $367 117%
Medcost $128 - $193 123%
Gmmi $131 126%
Quik Trip $131 126%
Carolina Behavioral Health $145 - $394 140%
First Health $181 174%
Healthgram $181 174%
Lifesynch Community Choice Care $189 182%
Multiplan $189 182%
Private Health Care Systems $189 182%
Beechstreet $193 186%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 301 Yadkin St, Albemarle, NC 28001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals