CMS Price Transparency Data

Group therapy session

Facility: Montefiore Mount Vernon Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $107
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Montefiore Mount Vernon Hospital is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.03x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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%)
Insurance Median: $107 (103%)
Ins. Median: $107 (103% 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
American Postal Workers $24 23%
UnitedHealthcare $24 - $127 23%
Healthfirst $26 - $127 25%
Metroplus $26 - $165 25%
Amidacare $63 61%
Blue Cross Blue Shield $63 - $313 61%
Emblem $63 - $152 61%
Fidelis $63 - $127 61%
Medicaid / KanCare $63 61%
Molina Healthcare Of Ny Affinity $63 - $175 61%
Mvp $63 - $130 61%
Wellcare $64 - $129 62%
Hamaspik $66 - $68 64%
Vnsny Choice $73 - $127 70%
Vnsny Select Health $73 70%
Point Comfort $127 122%
Villagecaremax $127 122%
Centerlight $131 - $175 126%
Partners Health Plan $133 128%
Longevity $138 133%
Elderplan $139 134%
Humana $139 134%
Aetna $307 - $343 296%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

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