CMS Price Transparency Data

Group therapy session

Facility: St Peter's Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $119
  • Cash Discount Price: $148
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Group therapy session at St Peter's Hospital is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $148. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.15x the Medicare baseline. Located in 315 South Manning Boulevard, Albany, NY.
Cash / Self-Pay
$148

Average discount available for prompt cash payment at this facility.

Insurance Median
$119

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: $148 (143%)
Insurance Median: $119 (115%)
Cash: $148 (143% of Medicare)
Ins. Median: $119 (115% 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
Blue Cross Blue Shield $22 - $618 21%
Blue Shield - Ca $22 21%
Blue Shield - Id (Regence) $22 21%
Blue Shield - Ny Highmark Northeastern $22 21%
Blue Shield - Ny Highmark Western $22 21%
Blue Shield - Pa (Highmark) $22 21%
Blue Shield - Wa (Regence) $22 21%
Aetna $24 - $113 23%
Medicaid / KanCare $36 - $228 35%
Mvp $51 - $55 49%
UnitedHealthcare $59 - $618 57%
Medicare (plans) $60 - $520 58%
1199 National Benefit Fund $113 109%
Allied Benefit Systems $113 109%
Asr Health Benefits $113 109%
Christian Brother Services $113 109%
Geha $113 109%
Lucent Health $113 109%
Luminare Health $113 109%
Medical Mutual $113 109%
Meritain $113 109%
Trustmark Small Business Benefits $113 109%
Allegiance $119 115%
American Postal Workers Secondary $119 115%
Cigna $119 115%
Diversified Administrators $119 115%
Health Partners $119 115%
Priority Health $119 115%
Tufts Health Plan $119 115%
Webtpa $119 115%
Harvard Pilgrim Healthcare $125 120%
Capital District Physicians Health Plan $150 145%
Emblem Health $171 165%
Nova $171 165%
Galaxy Health Network $182 175%
Health Republic $194 187%
Independent Health $194 187%
Magnacare $194 187%
Health New England $205 198%
Multiplan $205 198%
Phcs $205 198%
Albany County Correctional Facility $228 220%
Carelon Behavioral Health $462 - $540 445%
Bcn Domestic $618 595%
Blue Care Network $618 595%
Unicare $618 595%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 South Manning Boulevard, Albany, NY 12208
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals