CMS Price Transparency Data
Group therapy session
Facility: St Francis Hospital - the Heart Center
Billing Code: 90853 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90853
- Insurance Median: $183
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.76x Medicare
The contracted insurance negotiated median rate for a Group therapy session at St Francis Hospital - the Heart Center is $183. 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 1.76x the Medicare baseline. Located in 100 Port Washington Boulevard, Roslyn, NY.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$183
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: $183 (176%)
Ins. Median: $183 (176% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Zadroga | $37 | 36% |
| UnitedHealthcare | $59 - $412 | 57% |
| Surest | $84 | 81% |
| Blue Cross Blue Shield | $107 - $298 | 103% |
| Aetna | $109 - $140 | 105% |
| Centerlight Healthcare | $109 - $183 | 105% |
| Centers Plan For Healthy Living | $109 | 105% |
| Elderplan Inc. | $109 - $183 | 105% |
| Emblem Health | $109 - $246 | 105% |
| Fidelis Care New York | $109 - $412 | 105% |
| Health Plus | $109 - $412 | 105% |
| Healthspring | $109 | 105% |
| Independent Health | $109 - $183 | 105% |
| Liberty Health | $109 | 105% |
| Longevity Health Plan | $109 | 105% |
| Medicare (plans) | $109 - $115 | 105% |
| Mvp Health Plans | $109 - $183 | 105% |
| Orthonet - Uniformed Services Family Health Plan | $109 | 105% |
| Pmc | $109 | 105% |
| Senior Whole Health | $109 - $183 | 105% |
| Tricare | $109 | 105% |
| Universal Healthcare | $109 | 105% |
| Us Family Health Plan | $109 | 105% |
| Veterans Affairs | $109 | 105% |
| Health First | $111 - $412 | 107% |
| Humana | $112 | 108% |
| Agewell New York | $113 | 109% |
| Oscar Health | $115 | 111% |
| Partners Health Plan | $115 | 111% |
| Wellcare Health Plan Inc | $120 | 116% |
| Apwu | $140 | 135% |
| Brighton | $140 - $196 | 135% |
| Centivo | $140 | 135% |
| Cigna | $140 - $196 | 135% |
| Daniel H Cook | $140 | 135% |
| Local 1199 | $140 | 135% |
| Mail Handlers Benefit Plan | $140 | 135% |
| Meritain Health | $140 | 135% |
| Nalc | $140 | 135% |
| Nippon Life Insurance Company Of America | $140 | 135% |
| Salvation Army | $140 | 135% |
| Samba | $140 | 135% |
| Affinity Health Plan | $183 - $412 | 176% |
| Medicaid / KanCare | $183 | 176% |
| Allied Wellfare Fund | $196 | 189% |
| American Group Administrators | $196 | 189% |
| Bakery & Confectionery Union | $196 | 189% |
| Comprehensive Benefits Consultant | $196 | 189% |
| Guardian Life Insurance Company Of America | $196 | 189% |
| Maloney And Assoc | $196 | 189% |
| Multiplan | $196 | 189% |
| Performax | $196 | 189% |
| Phcs | $196 | 189% |
| Pomco | $196 | 189% |
| Tpa Inc | $196 | 189% |
| Unicare | $196 | 189% |
| United Employees Health Plan | $196 | 189% |
| Coventry | $207 - $232 | 199% |
| American Plan Administrators | $246 | 237% |
| Amerihealth Administrators | $246 | 237% |
| Benefit Services | $246 | 237% |
| Ghi Cbp Ny City Employee Alternate | $246 | 237% |
| International Benefit Administrator | $246 | 237% |
| Ultra Benefits Inc. | $246 | 237% |
| Galaxy | $252 | 243% |
| Three Rivers Provider Network | $252 | 243% |
| Aither Health | $280 | 270% |
| Alpha Care | $280 | 270% |
| Dentaquest | $280 | 270% |
| Self Pay | $298 | 287% |