CMS Price Transparency Data

Group therapy session

Facility: Peak Behavioral Health Services, LLC

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $175
Cash Discount Price: $258
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Peak Behavioral Health Services, LLC is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $258. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.69x the Medicare baseline. Located in 5045 McNutt Road (Bldg's A, B, C & D), Santa Teresa, NM.

Cash / Self-Pay

$258

Average discount available for prompt cash payment at this facility.

Insurance Median

$175

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: $258 (249%)

Insurance Median: $175 (169%)

Cash: $258 (249% of Medicare)

Ins. Median: $175 (169% 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
Wellpoint	$25 - $33	24%
Tricare	$32 - $378	31%
Mhn	$43 - $149	41%
UnitedHealthcare	$43 - $251	41%
Medicare (plans)	$54 - $216	52%
Humana	$61 - $190	59%
Assurant Health	$100	96%
Presbyterian Centennial	$100	96%
Value Options Comm	$100	96%
Bas Health Plans	$117	113%
El Paso Health Chip	$120	116%
Preferred Administrators	$120	116%
Molina Marketplace	$130	125%
Superior Healthplan	$140	135%
Mhbp	$144	139%
Blue Cross Blue Shield	$169 - $315	163%
Aetna	$180 - $237	173%
Compsych	$200	193%
Cigna	$204	197%
Molina Centennial	$210 - $275	202%
United Behavioral Health	$216	208%
United Behavioral Shared Services	$216	208%
Point Comfort Underwriters	$275	265%
Presbyterian Health Plan	$310	299%

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 $258.
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 Peak Behavioral Health Services, LLC 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.