CMS Price Transparency Data

Group therapy session

Facility: Samaritan Pacific Community Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $34
Cash Discount Price: $41
vs. Medicare Baseline: 0.33x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Samaritan Pacific Community Hospital is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.33x the Medicare baseline. Located in 930 Sw Abbey Street, Newport, OR.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $41 (40%)

Insurance Median: $34 (33%)

Cash: $41 (40% of Medicare)

Ins. Median: $34 (33% 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
Devoted Health	$6 - $32	6%
Humana	$6 - $32	6%
Pacificsource	$6 - $59	6%
Providence	$6 - $69	6%
Regence	$6 - $83	6%
Samaritan	$6 - $64	6%
Aetna	$16 - $60	15%
Cigna	$16 - $52	15%
Healthnet	$16 - $54	15%
Moda	$16 - $69	15%
Ihn	$29 - $67	28%
First Choice	$34 - $60	33%

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 $41.
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 Samaritan Pacific Community 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.