CMS Price Transparency Data

Group therapy session

Facility: Centrastate Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $24
Cash Discount Price: $116
vs. Medicare Baseline: 0.23x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Centrastate Medical Center is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.23x the Medicare baseline. Located in 901 West Main Street, Freehold, NJ.

Cash / Self-Pay

$116

Average discount available for prompt cash payment at this facility.

Insurance Median

$24

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: $116 (112%)

Insurance Median: $24 (23%)

Cash: $116 (112% of Medicare)

Ins. Median: $24 (23% 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
Allied Benefit Systems [5046]	$24	23%
Centivo [5405]	$24	23%
Cigna	$24	23%
Evolution Healthcare [5438]	$24	23%
Healthez [5445]	$24	23%
Iaa - Insurance Administrators of America [5482]	$24	23%
Mvp Health Care [5197]	$24	23%
Nalc [5198]	$24	23%
Seafarers Health and Benefits Plan [5343]	$24	23%
Tufts Health Plan [5344]	$24	23%
Webtpa [5447]	$24	23%
Blue Cross Blue Shield	$28	27%
Medicaid / KanCare	$28 - $32	27%
Untd Hlth Community Plan Behavioral Health [5293]	$28	27%
Untd Hlth Community Plan [5034]	$28	27%
Aetna	$30	29%
Horizon Nj Health [5021]	$34	33%
Wtc Health Program [5273]	$37	36%
Amerihealth Administrators Supplemental [5512]	$202	195%
Amerihealth Medigap [5049]	$202	195%
Amerihealth [5008]	$202	195%

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 $116.
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 Centrastate 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.