CMS Price Transparency Data

Group therapy session

Facility: Cleveland Clinic

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $92
  • Cash Discount Price: $120
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Cleveland Clinic is $92. 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 0.89x the Medicare baseline. Located in 9500 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$120

Average discount available for prompt cash payment at this facility.

Insurance Median
$92

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: $92 (89%)
Cash: $120 (116% of Medicare)
Ins. Median: $92 (89% 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
Summacare $16 - $88 15%
Cigna $21 - $144 20%
Aetna $24 - $224 23%
Blue Cross Blue Shield $24 - $156 23%
Devoted Health $24 - $86 23%
Humana $24 - $156 23%
The Health Plan $24 - $123 23%
United $24 - $142 23%
UnitedHealthcare $24 - $143 23%
Upmc $24 - $134 23%
Valor $24 - $86 23%
Communicare $25 - $90 24%
Perennial Health $26 - $93 25%
Pphp $26 - $94 25%
Zing Health $26 - $94 25%
Buckeye $29 - $127 28%
Caresource $29 - $121 28%
Paramount $29 - $124 28%
Amerihealth $31 30%
Molina $31 - $127 30%
Cc Ehp $46 - $115 44%
Oscar $55 - $71 53%
Mmo $81 - $157 78%
Amish Community Aid Plan $83 - $101 80%
Ohcp $87 - $89 84%
Aultcare $90 - $96 87%
Ohio Healthy $90 - $129 87%
United Bh $90 - $133 87%
Omas $92 - $112 89%
Healthsmart $101 - $123 97%
Php $110 106%
Phphi $110 - $134 106%
Clarity Health $120 - $146 116%
Gms $129 - $157 124%
Medical Benefit Corp $129 124%
Parkview Health Plan $129 124%
Quality Care Partners $129 - $157 124%
Consociate Health $138 - $168 133%
Community Health Alliance $147 142%
Frontpath $166 160%
Managed Care Services $166 160%
Multiplan $166 - $202 160%
Tertiary Care Network $166 160%
Three Rivers $166 - $202 160%
Usa Managed Care $202 195%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9500 Euclid Avenue, Cleveland, OH 44195
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals