CMS Price Transparency Data

Group therapy session

Facility: Memorial Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $200
Cash Discount Price: $334
vs. Medicare Baseline: 1.93x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Memorial Hospital is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $334. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.93x the Medicare baseline. Located in 715 South Taft Avenue, Fremont, OH.

Cash / Self-Pay

$334

Average discount available for prompt cash payment at this facility.

Insurance Median

$200

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: $334 (322%)

Insurance Median: $200 (193%)

Cash: $334 (322% of Medicare)

Ins. Median: $200 (193% 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
Health Ohio Network	$16 - $514	15%
Health Alliance Plan	$17 - $514	16%
Aetna	$26 - $411	25%
Blue Cross Blue Shield	$29 - $321	28%
Frontpath	$29 - $97	28%
Molina Healthcare Of Ohio	$29 - $514	28%
Summacare	$29 - $397	28%
Caresource	$30 - $360	29%
UnitedHealthcare	$32 - $514	31%
Buckeye Community Health Plan	$56 - $247	54%
Medical Mutual Of Ohio	$95 - $269	92%
Multiplan	$95 - $269	92%
Meridian Health Plan Of Mi	$99 - $334	95%
Amerihealth	$118 - $334	114%
Cigna	$236 - $254	227%
Humana	$257 - $334	248%
Paramount Healthcare Inc	$423 - $514	408%

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 $334.
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 Memorial 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.