CMS Price Transparency Data

Group therapy session

Facility: Montefiore Mount Vernon Hospital

Billing Code: 90853 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$99
about 1.0× the $104 Medicare rate · typically $41–$177
modeled estimate · not a bill or quote
What this hospital charges insurers
$73
Below the fair price — a good deal
about $26 under the fair price · 0.7× Medicare
Medicare pays $104 Fair price $99 This hospital $73

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 $73

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 $99 (about 1.0× the $104 Medicare rate). Montefiore Mount Vernon Hospital charges insurers about $73 — below the fair price — a good deal. Located in Mount Vernon, 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 $24 - $127 23%
Blue Cross Blue Shieldmajor $63 - $313 61%
Aetnamajor $307 - $343 296%
Humanamajor $139 134%
Fidelis Care $63 - $127 61%
Molina $63 - $175 61%
MVP Health Care $63 - $130 61%
SelectHealth $73 70%
WellCare $64 - $129 62%
+ 13 smaller / regional plans $24 - $175
Government programs also on file: Medicaid.

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Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals