CMS Price Transparency Data

Group therapy session

Facility: Ascension St John Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $89
Cash Discount Price: $210
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Ascension St John Medical Center is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $210. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.86x the Medicare baseline. Located in 1923 South Utica Avenue, Tulsa, OK.

Cash / Self-Pay

$210

Average discount available for prompt cash payment at this facility.

Insurance Median

$89

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: $210 (202%)

Insurance Median: $89 (86%)

Cash: $210 (202% of Medicare)

Ins. Median: $89 (86% 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
Aetna	$28	27%
First Health	$36	35%
Blue Cross Blue Shield	$44 - $92	42%
Champva	$88	85%
Community Care - St John Network Senior - Govt	$88	85%
Communitycare Senior	$88	85%
Life Pace	$88	85%
Longevity Health Plan Of Oklahoma	$88	85%
Medicare (plans)	$88	85%
UnitedHealthcare	$88 - $352	85%
Va Community Care Network	$88	85%
Veterans Administration	$88	85%
Humana	$89	86%
Communitycare (Standard)	$97	93%
Community Care (Select) 7/1/13	$106	102%
Ccl&H	$114	110%
Smarthealth	$123	119%
Community Care Smarthealth	$132 - $211	127%
Communitycare (Select)	$132 - $202	127%
Connect Health Benefit	$176	170%
Evolutions	$176	170%
Kempton Group Administrators	$198	191%

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 $210.
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 Ascension St John Medical Center 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.