CMS Price Transparency Data

Group therapy session

Facility: NYU Langone Hospitals

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $165
Cash Discount Price: $37
vs. Medicare Baseline: 1.59x Medicare

The contracted insurance negotiated median rate for a Group therapy session at NYU Langone Hospitals is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.59x the Medicare baseline. Located in 550 First Avenue, New York, NY.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$165

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: $37 (36%)

Insurance Median: $165 (159%)

Cash: $37 (36% of Medicare)

Ins. Median: $165 (159% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Fidelis	$24 - $43	23%
Healthfirst	$24 - $107	23%
Healthplus	$24	23%
Amida	$27	26%
1199	$35	34%
Hip	$82 - $200	79%
UnitedHealthcare	$96 - $227	92%
Ghi	$109 - $219	105%
Medicare (plans)	$109	105%
Wellcare	$109	105%
Centerlight	$112	108%
Metroplus	$128 - $217	123%
Magnacare	$137	132%
Aetna	$164 - $274	158%
Cigna	$164	158%
Hamaspik	$164	158%
Oxford	$202 - $231	195%
Multiplan	$214	206%
Blue Cross Blue Shield	$928 - $1,160	894%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $37.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90853.

Insurance In-Network Protection Plan

Contact your insurance company to confirm NYU Langone Hospitals is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90853.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.