CMS Price Transparency Data

Group therapy session

Facility: St Mary's Healthcare

Billing Code: 90853 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$118

about 1.1× the $104 Medicare rate · typically $59–$131

modeled estimate · not a bill or quote

What this hospital charges insurers

$131

About the fair price

about $13 over the fair price · 1.3× Medicare

Medicare pays $104 Fair price $118 This hospital $131 Cash price $94 Hospital's list price $137

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $24 Priciest $131

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Group therapy session is about $118 (about 1.1× the $104 Medicare rate). St Mary's Healthcare charges insurers about $131, or about $94 in cash — about the fair price. Located in Amsterdam, NY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$52	50%
Blue Cross Blue Shieldmajor	$76 - $185	73%
Aetnamajor	$77 - $154	74%
Humanamajor	$103 - $133	99%
CDPHP	$72 - $144	69%
+ 3 smaller / regional plans	$52 - $398

Government programs also on file: Medicare, Medicaid, Military & VA.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 94), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90853.

Insurance Before you use insurance

Call your insurance company to confirm St Mary's Healthcare is in-network.
Ask your insurer whether prior approval is required for CPT code 90853.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Mary's Healthcare

Compare: Group therapy session at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.