CMS Price Transparency Data

Group therapy session

Facility: Marymount Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $97
  • Cash Discount Price: $120
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Marymount Hospital is $97. 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 0.93x the Medicare baseline. Located in 12300 McCracken Road, Garfield Heights, OH.
Cash / Self-Pay
$120

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $97 (93%)
Cash: $120 (116% of Medicare)
Ins. Median: $97 (93% 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.

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
Cigna $36 - $96 35%
Oscar $55 - $71 53%
Summacare $62 - $86 60%
Cc Ehp $72 - $73 69%
United $77 - $99 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%
The Health Plan $86 - $110 83%
UnitedHealthcare $86 - $114 83%
Upmc $86 - $110 83%
Valor $86 83%
Ohcp $89 86%
Communicare $90 87%
Omas $92 89%
Perennial Health $93 90%
Pphp $94 91%
Zing Health $94 91%
Paramount $96 92%
Buckeye $98 94%
Molina $98 94%
United Bh $98 94%
Caresource $99 95%
Ohio Healthy $99 95%
Healthsmart $101 97%
Amerihealth $102 98%
Php $110 106%
Phphi $110 106%
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

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12300 McCracken Road, Garfield Heights, OH 44125
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals