CMS Price Transparency Data

Group therapy session

Facility: Artesia General Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $69
Cash Discount Price: $47
vs. Medicare Baseline: 0.66x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Artesia General Hospital is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.66x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$47

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

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: $47 (45%)

Insurance Median: $69 (66%)

Cash: $47 (45% of Medicare)

Ins. Median: $69 (66% 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
Zelis	$20 - $108	19%
First Health	$29 - $74	28%
Blue Cross Blue Shield	$44 - $90	42%
Geha	$52 - $90	50%
Omni Networks	$52 - $57	50%
Three Rivers Provider Network	$56 - $62	54%
Cigna	$63 - $74	61%
UnitedHealthcare	$63 - $90	61%
Galaxy Health	$67 - $74	65%
Multiplan	$67 - $75	65%
One Health Plan	$67 - $74	65%
United Payors & United Providers	$69 - $76	66%
Providence Risk & Insurance Services	$70 - $179	67%
Molina Healthcare Of New Mexico	$73 - $151	70%
Presbyterian Health Plan	$73 - $90	70%
Triwest	$88	85%
Humana	$90 - $99	87%
Vistacare Hospice	$90	87%
New Mexico Health Connections	$152	146%

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 $47.
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 Artesia General 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.