CMS Price Transparency Data

Group therapy session

Facility: Samaritan Hospital of Troy, New York

Billing Code: 90853 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$89

about 0.9× the $104 Medicare rate · typically $35–$153

modeled estimate · not a bill or quote

What this hospital charges insurers

$51

Below the fair price — a good deal

about $38 under the fair price · 0.5× Medicare

Medicare pays $104 Fair price $89 This hospital $51 Cash price $105 Hospital's list price $145

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 $51

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 $89 (about 0.9× the $104 Medicare rate). Samaritan Hospital of Troy, New York charges insurers about $51, or about $105 in cash — below the fair price — a good deal. Located in Troy, NY.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser 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	$36 - $228	35%
Blue Cross Blue Shieldmajor	$22 - $455	21%
Aetnamajor	$24 - $113	23%
Cignamajor	$61 - $119	59%
Humanamajor	$17 - $61	16%
Kaiser Permanentemajor	$61	59%
Ambetter (Centene)	$61	59%
AmeriHealth	$61	59%
AvMed	$61	59%
Bright Health	$61	59%
CareSource	$61	59%
Clover Health	$61	59%
Dean Health Plan	$61	59%
Fidelis Care	$61	59%
Friday Health	$61	59%
GEHA	$45 - $113	43%
Geisinger	$61	59%
Harvard Pilgrim	$61 - $125	59%
Health Net	$61	59%
HealthLink	$61	59%
HealthPartners	$61 - $119	59%
Independent Health	$61 - $194	59%
MagnaCare	$61 - $194	59%
Medica	$61	59%
Medical Mutual	$61 - $113	59%
Meridian	$61	59%
Moda Health	$61	59%
Molina	$61	59%
MVP Health Care	$51 - $61	49%
Oscar Health	$61	59%
PacificSource	$61	59%
Paramount	$61	59%
Presbyterian	$61	59%
Priority Health	$61 - $119	59%
Providence Health Plan	$61	59%
Sanford Health Plan	$61	59%
Security Health Plan	$61	59%
SelectHealth	$61	59%
Sentara	$61	59%
Tufts Health Plan	$61 - $119	59%
UCare	$61	59%
UniCare	$61 - $193	59%
UPMC Health Plan	$61	59%
WellCare	$61	59%
WellMed	$61	59%
WellSense	$61	59%
+ 1046 smaller / regional plans	$18 - $228

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

Excludes 42 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 105), 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 Samaritan Hospital of Troy, New York 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 Samaritan Hospital of Troy, New York

Compare: Group therapy session at other NY hospitals

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