CMS Price Transparency Data

Group therapy session

Facility: Sanford Medical Center Bismarck

Billing Code: 90853 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$93

about 0.9× the $104 Medicare rate · typically $60–$111

modeled estimate · not a bill or quote

What this hospital charges insurers

$94

About the fair price

about $1 over the fair price · 0.9× Medicare

Medicare pays $104 Fair price $93 This hospital $94 Cash price $217 Hospital's list price $271

How we calculate the fair BaseRate →

How this hospital compares to other ND hospitals

A typical price — 5 charge more and 3 charge less, among the 9 ND hospitals compared.

Cheapest $23 Priciest $603

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

A fair price for a Group therapy session is about $93 (about 0.9× the $104 Medicare rate). Sanford Medical Center Bismarck charges insurers about $94, or about $217 in cash — about the fair price. Located in Bismarck, ND.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$41 - $1,461	40%
Blue Cross Blue Shieldmajor	$26 - $1,619	25%
Aetnamajor	$41 - $1,521	40%
Cignamajor	$96 - $1,575	92%
Health Net	$96 - $1,575	92%
HealthPartners	$41 - $1,418	40%
Medica	$94 - $1,656	91%
Sanford Health Plan	$24 - $1,625	23%
Security Health Plan	$59 - $962	57%
UCare	$40 - $1,538	39%
+ 2 smaller / regional plans	$42 - $1,575

Government programs also on file: Medicare.

Excludes 1 rental-network / third-party entry (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 217), 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 Sanford Medical Center Bismarck 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 Sanford Medical Center Bismarck

Compare: Group therapy session at other ND hospitals

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