CMS Price Transparency Data

Group therapy session

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $83
Cash Discount Price: $59
vs. Medicare Baseline: 0.80x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Mary Hitchcock Memorial Hospital is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.80x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$83

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: $59 (57%)

Insurance Median: $83 (80%)

Cash: $59 (57% of Medicare)

Ins. Median: $83 (80% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Amerihealth Caritas Nh	$11 - $28	11%
Beacon Health Strategies/Carelon	$11 - $27	11%
Granite State Health Plan	$11 - $29	11%
Wellsense Health Plan	$11 - $109	11%
Harvard Pilgrim Health Care Of Ne	$18 - $123	17%
Blue Cross Blue Shield	$24 - $403	23%
Martin'S Point Generations Advantage	$24 - $104	23%
Martin'S Point Health Care	$24 - $104	23%
Mvp	$24 - $129	23%
UnitedHealthcare	$24 - $147	23%
Aetna	$25 - $135	24%
Ambetter / Centene	$25 - $223	24%
Cigna	$25 - $132	24%
Wellcare Health Plans	$25 - $108	24%
Mass General Brigham Health Plan	$64 - $119	62%
Tufts Health Plan	$71 - $112	68%
Maine Community Health Options	$122 - $141	118%
Coventry	$167	161%
First Health/Hcvm	$167	161%
Phcs	$173	167%
Corvel	$177	171%
Ccmsi	$182	175%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $59.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90853.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mary Hitchcock Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90853.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.