CMS Price Transparency Data

Group therapy session

Facility: Riverview Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $310
Cash Discount Price: $102
vs. Medicare Baseline: 2.99x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Riverview Medical Center is $310. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.99x the Medicare baseline. Located in One Riverview Plaza, Red Bank, NJ.

Cash / Self-Pay

$102

Average discount available for prompt cash payment at this facility.

Insurance Median

$310

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: $102 (98%)

Insurance Median: $310 (299%)

Cash: $102 (98% of Medicare)

Ins. Median: $310 (299% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 299% of the Medicare baseline (a markup of 199%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Karna	$39	38%
Aetna	$58 - $372	56%
Clover	$74	71%
Seoul Medical Group	$90	87%
Blue Cross Blue Shield	$102	98%
Vaccn	$102	98%
Wellcare	$102	98%
United Community/Americhoice	$108	104%
UnitedHealthcare	$123 - $335	119%
Qualcare	$136 - $363	131%
Oxford	$250	241%
Horizon	$263 - $333	253%
Bergen Risk	$310	299%
Cigna	$330 - $395	318%
Activecare First McO	$351	338%
Multiplan - PHCS	$351	338%
Amerihealth	$357 - $405	344%
Brighton Health Plan	$372	358%

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 $102.
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 Riverview Medical Center 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.