CMS Price Transparency Data

Group therapy session

Facility: Euclid Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $100
Cash Discount Price: $120
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Euclid Hospital is $100. 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 0.96x the Medicare baseline. Located in 18901 Lake Shore Boulevard, Euclid, OH.

Cash / Self-Pay

$120

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $100 (96%)

Cash: $120 (116% of Medicare)

Ins. Median: $100 (96% 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
Oscar	$55 - $71	53%
Summacare	$65 - $86	63%
Cc Ehp	$72 - $73	69%
The Health Plan	$77 - $110	74%
Aultcare	$79	76%
Amish Community Aid Plan	$83 - $92	80%
Aetna	$86 - $184	83%
Blue Cross Blue Shield	$86 - $147	83%
Devoted Health	$86	83%
Humana	$86 - $156	83%
Mmo	$86 - $110	83%
United	$86 - $113	83%
UnitedHealthcare	$86 - $114	83%
Upmc	$86 - $110	83%
Valor	$86	83%
Cigna	$88 - $96	85%
Ohcp	$89	86%
Communicare	$90	87%
Omas	$92	89%
Perennial Health	$93	90%
Pphp	$94	91%
Ohio Healthy	$99	95%
Healthsmart	$101	97%
Paramount	$108	104%
Buckeye	$110	106%
Molina	$110	106%
Php	$110	106%
United Bh	$112	108%
Caresource	$113	109%
Amerihealth	$116	112%
Gms	$129	124%
Medical Benefit Corp	$129	124%
Quality Care Partners	$129	124%
Consociate Health	$138	133%
Frontpath	$166	160%
Managed Care Services	$166	160%
Multiplan	$166	160%
Tertiary Care Network	$166	160%
Three Rivers	$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 Euclid Hospital 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.