CMS Price Transparency Data

Group therapy session

Facility: Jamaica Hospital Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $127
Cash Discount Price: $139
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Jamaica Hospital Medical Center is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $139. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.22x the Medicare baseline. Located in 89Th Avenue and Van Wyck Expressway, Jamaica, NY.

Cash / Self-Pay

$139

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $139 (134%)

Insurance Median: $127 (122%)

Cash: $139 (134% of Medicare)

Ins. Median: $127 (122% 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
Ghi	$25 - $112	24%
United Behavioral Health	$31 - $52	30%
1999 National Benefit Fund	$35	34%
World Trade Center Program	$38	37%
Healthfirst	$107	103%
Valueoptions	$119	115%
Fidelis	$120 - $126	116%
Hotel Trades Council	$125 - $1,912	120%
Aetna	$126	121%
Beacon Health Strategies	$126	121%
Centerlight Healthcare	$126	121%
Empire	$126 - $156	121%
Metroplus	$126 - $139	121%
UnitedHealthcare	$126	121%
Elderplan	$129	124%
Vns	$129	124%
Wellcare Of Ny	$131	126%
Empire Blue Priority	$133	128%
Humana	$134	129%
Senior Whole Health	$134	129%
Hamaspik Choice	$145	140%
Magnacare	$145 - $500	140%
Centers Plan For Healthy Living	$158	152%
Emblemhealth	$208	200%
Create Health Plan	$371	357%
Centivo	$456	439%

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 $139.
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 Jamaica Hospital 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.