CMS Price Transparency Data

Group therapy session

Facility: Arthur G James Cancer Hospital and Research Institute

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $256
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.47x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Arthur G James Cancer Hospital and Research Institute is $256. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.47x the Medicare baseline. Located in 460 W 10Th Ave, Columbus, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$256

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%)

Insurance Median: $256 (247%)

Ins. Median: $256 (247% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 247% of the Medicare baseline (a markup of 147%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Healthspan	$62 - $5,413	60%
Medigold	$62 - $315	60%
Upper Ohio Valley	$62 - $5,413	60%
Humana	$63 - $5,521	61%
Medicare (plans)	$63 - $5,467	61%
Medicaid / KanCare	$72 - $500	69%
Aetna	$75 - $5,388	72%
United	$79 - $1,309	76%
Caresource	$94 - $710	91%
Mmo	$94 - $1,214	91%
Molina	$94 - $5,388	91%
Odrc	$99 - $585	95%
Blue Cross Blue Shield	$104 - $1,363	100%
Buckeye Community	$105 - $705	101%
Amerihealth	$106 - $775	102%
Osu Health Plan	$130 - $952	125%
Lifetrac	$185 - $978	178%
Ohio Ppo	$186 - $944	179%
Ohiohealth	$204 - $1,050	197%
Cigna	$206 - $1,079	198%
Frontpath	$227 - $1,150	219%
Healthsmart	$256 - $1,294	247%
Multiplan	$264 - $1,337	254%
Ohio Dept Of Health	$4,289	4132%

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 $X.
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 Arthur G James Cancer Hospital and Research Institute 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.