CMS Price Transparency Data

Group therapy session

Facility: Albany Medical Center Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $29
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 0.28x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Albany Medical Center Hospital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.28x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $30 (29%)
Insurance Median: $29 (28%)
Cash: $30 (29% of Medicare)
Ins. Median: $29 (28% 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.

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
UnitedHealthcare $8 - $121 8%
Emblem $9 - $121 9%
Emblem_Ghi $9 - $121 9%
Empire Plan Nyship $9 - $121 9%
Magnacare $9 - $121 9%
Multiplan $9 - $128 9%
Blue Shield $11 - $85 11%
Medicaid / KanCare $12 - $23 12%
Cdphp $16 - $180 15%
Blue Cross Blue Shield $18 - $180 17%
Medicare (plans) $18 - $30 17%
Tricare $18 - $28 17%
Fidelis $19 - $187 18%
Hamaspik $20 - $188 19%
Mvp $20 - $104 19%
Cigna $21 - $47 20%
Blue Shield Highmark $23 - $56 22%
Aetna $25 - $53 24%
Nascentia $26 - $30 25%
Emblem Health Ghi $27 - $60 26%
Carelon Beacon Behavioral $35 - $49 34%
Nascentia Health Options $38 37%
Nys Department Of Corrections $55 - $60 53%
Mvp Essential Plan $172 166%
Mvp Commercial $284 - $373 274%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43 New Scotland Avenue, Mail Code 34, Albany, NY 12208
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals