CMS Price Transparency Data

Group therapy session

Facility: Long Island Community Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $85
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 0.82x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Long Island Community Hospital is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.82x the Medicare baseline. Located in 101 Hospital Road, Patchogue, NY.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$85

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: $36 (35%)
Insurance Median: $85 (82%)
Cash: $36 (35% of Medicare)
Ins. Median: $85 (82% 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
Local 1199 $42 40%
Magellan $55 53%
Multiplan $55 53%
Oscar Health Exchange $58 56%
Coventry $63 61%
Longevity Health $68 66%
Galaxy $76 73%
Aarp $85 82%
Aetna $85 82%
Beacon Health Options $85 82%
Blue Cross Blue Shield $85 - $150 82%
Centerlight $85 82%
Cigna $85 82%
Emblem Ghi $85 82%
Fidelis $85 82%
Humana $85 82%
Integra $85 82%
Medicare (plans) $85 82%
UnitedHealthcare $85 82%
Agewell $88 85%
Elderplan Inc. $93 90%
Wellcare $93 90%
Nexus Nyu $274 264%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 Hospital Road, Patchogue, NY 11772
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals