CMS Price Transparency Data

Group therapy session

Facility: Triangle Springs

Billing Code: 90853 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$88

about 0.8× the $104 Medicare rate · typically $48–$164

modeled estimate · not a bill or quote

What this hospital charges insurers

$271

Well above the fair price

about $183 over the fair price · 2.6× Medicare

Medicare pays $104 Fair price $88 This hospital $271 Cash price $280 Hospital's list price $292

How we calculate the fair BaseRate →

How this hospital compares to other NC hospitals

Highest price of the 9 NC hospitals we have prices for — worth calling around.

Cheapest $25 Priciest $271

Black dot = this hospital, among the 9 NC hospitals with a price for this procedure. Full list below.

A fair price for a Group therapy session is about $88 (about 0.8× the $104 Medicare rate). Triangle Springs charges insurers about $271, or about $280 in cash — well above the fair price. Located in Raleigh, NC.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $88. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$229	221%
Blue Cross Blue Shieldmajor	$200 - $246	193%
Aetnamajor	$235	226%
Cignamajor	$270	260%
Humanamajor	$268 - $350	258%
Ambetter (Centene)	$225	217%
Bright Health	$268 - $330	258%
Cigna HealthSpring	$260	251%
Friday Health	$325	313%
Health Net	$350 - $530	337%
+ 12 smaller / regional plans	$219 - $710

Government programs also on file: Military & VA.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 280), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90853.

Insurance Before you use insurance

Call your insurance company to confirm Triangle Springs is in-network.
Ask your insurer whether prior approval is required for CPT code 90853.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Triangle Springs

Behavioral health counseling (group)

Compare: Group therapy session at other NC hospitals

Insurance negotiated median for the same procedure, sorted lowest first.