CMS Price Transparency Data

Group therapy session

Facility: Mercy Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $88
Cash Discount Price: $120
vs. Medicare Baseline: 0.85x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Mercy Medical Center is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.85x the Medicare baseline. Located in 1320 Mercy Drive Nw, Canton, OH.

Cash / Self-Pay

$120

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $120 (116%)

Insurance Median: $88 (85%)

Cash: $120 (116% of Medicare)

Ins. Median: $88 (85% 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
Summacare	$16 - $157	15%
Aetna	$24 - $224	23%
Blue Cross Blue Shield	$24 - $118	23%
Cigna	$24 - $96	23%
Humana	$24 - $85	23%
The Health Plan	$24 - $184	23%
United	$24 - $93	23%
Communicare	$25 - $90	24%
Mmo	$25 - $169	24%
Perennial Health	$26 - $92	25%
Zing Health	$26 - $94	25%
Aultcare	$28 - $75	27%
Buckeye	$29 - $96	28%
Caresource	$29 - $96	28%
Amerihealth	$31 - $103	30%
Molina	$31 - $98	30%
Oscar	$55 - $71	53%
Cc Ehp	$72 - $73	69%
Amish Community Aid Plan	$83 - $92	80%
Ohcp	$87 - $89	84%
Immergrun	$92 - $168	89%
Omas	$92 - $112	89%
Ohio Healthy	$99	95%
Php	$110	106%
Phphi	$110 - $134	106%
Gms	$129 - $157	124%
Medical Benefit Corp	$129	124%
Consociate Health	$138	133%
Frontpath	$166	160%
Managed Care Services	$166	160%
Multiplan	$166 - $202	160%
Tertiary Care Network	$166	160%

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 $120.
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 Mercy Medical Center 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.