CMS Price Transparency Data

Group therapy session

Facility: Cleveland Clinic Children's Hospital for Rehab

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $129
  • Cash Discount Price: $120
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Cleveland Clinic Children's Hospital for Rehab is $129. 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 1.24x the Medicare baseline. Located in 2801 Martin Luther King, Jr Drive, Cleveland, OH.
Cash / Self-Pay
$120

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

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: $129 (124%)
Cash: $120 (116% of Medicare)
Ins. Median: $129 (124% 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 - $79 35%
Oscar $55 - $71 53%
Aultcare $63 61%
Amish Community Aid Plan $83 - $92 80%
Ohcp $89 86%
Summacare $91 - $92 88%
Buckeye $100 - $122 96%
Healthsmart $101 97%
United $106 - $179 102%
Php $110 106%
Phphi $110 106%
The Health Plan $110 106%
Upmc $110 106%
Aetna $118 - $184 114%
UnitedHealthcare $121 - $159 117%
Blue Cross Blue Shield $125 - $176 120%
Gms $129 124%
Medical Benefit Corp $129 124%
Quality Care Partners $129 124%
Cc Ehp $130 125%
Consociate Health $138 133%
Ohio Healthy $147 142%
Managed Care Services $166 160%
Multiplan $166 160%
Three Rivers $166 160%
Paramount $173 167%
Molina $176 170%
Caresource $179 172%
Amerihealth $184 177%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2801 Martin Luther King, Jr Drive, Cleveland, OH 44104
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens