CMS Price Transparency Data
Group therapy session
Facility: St Charles Madras
Billing Code: 90853 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90853
- Insurance Median: $64
- Cash Discount Price: $60
- vs. Medicare Baseline: 0.62x Medicare
The contracted insurance negotiated median rate for a Group therapy session at St Charles Madras is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.62x the Medicare baseline. Located in 470 Ne A Street, Madras, OR.
Cash / Self-Pay
$60
Average discount available for prompt cash payment at this facility.
Insurance Median
$64
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: $60 (58%)
Insurance Median: $64 (62%)
Cash: $60 (58% of Medicare)
Ins. Median: $64 (62% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Advanced Health [534] | $13 - $141 | 13% |
| Allcare Health Plan [538] | $13 - $141 | 13% |
| Cascade Health Alliance [532] | $13 - $141 | 13% |
| Columbia Pacific Coordinated Care Llc [539] | $13 - $141 | 13% |
| Health Share Care Oregon [526] | $13 - $141 | 13% |
| Health Share Kaiser [543] | $13 - $141 | 13% |
| Health Share Ohsu Ohp [552] | $13 - $141 | 13% |
| Health Share Providence [548] | $13 - $141 | 13% |
| Health Share [537] | $13 - $141 | 13% |
| Intercommunity Health [530] | $13 - $141 | 13% |
| Jackson Care Connect [542] | $13 - $141 | 13% |
| Medicaid / KanCare | $13 - $141 | 13% |
| Primary Health Of Jospehine County Llc [547] | $13 - $141 | 13% |
| Umpqua Health [533] | $13 - $141 | 13% |
| Willamette Valley Community Health [536] | $13 - $141 | 13% |
| Yamhill County Coordinated Care Org [550] | $13 - $141 | 13% |
| Law Enforcement [701] | $15 - $171 | 14% |
| Aetna | $18 - $300 | 17% |
| Ageright Advantage [142] | $18 - $83 | 17% |
| Champ Va [700] | $18 - $83 | 17% |
| Cigna | $18 - $217 | 17% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $18 - $83 | 17% |
| Devoted Health Inc [145] | $18 - $83 | 17% |
| Health Market Care Assured [134] | $18 - $83 | 17% |
| Health Net Med Adv [135] | $18 - $83 | 17% |
| Humana | $18 - $83 | 17% |
| Indian Health [704] | $18 - $83 | 17% |
| Kaiser Permanente Med Adv [136] | $18 - $83 | 17% |
| Medicare (plans) | $18 - $96 | 17% |
| Samaritan Health Plan Med Adv [141] | $18 - $83 | 17% |
| Unicare [133] | $18 - $83 | 17% |
| UnitedHealthcare | $18 - $83 | 17% |
| Veterans [706] | $18 - $83 | 17% |
| Wellcare [132] | $18 - $83 | 17% |
| Us Benefits [326] | $19 - $217 | 18% |
| Blue Cross Blue Shield | $20 - $272 | 19% |
| Providence Health Plan [347] | $21 - $301 | 20% |
| Tricare | $23 - $108 | 22% |
| Rocky Mountain Administrators [405] | $24 - $276 | 23% |
| Rx Internal [4100003] | $25 - $281 | 24% |
| First Choice Health [317] | $26 - $298 | 25% |
| Kaiser Permanente [334] | $26 - $298 | 25% |
| Moda [310] | $26 - $296 | 25% |
| Samaritan [376] | $26 - $298 | 25% |
| Meritain Health [300] | $27 - $300 | 26% |
| Health Net [340] | $29 - $324 | 28% |
| Administrative Concepts Inc [402] | $30 - $338 | 29% |
| First Health [339] | $30 - $338 | 29% |
| Manhattan Life Insurance Company [379] | $30 - $338 | 29% |
| Pacificsource [345] | $30 - $188 | 29% |
| Philadelphia American Life Insurance Company [395] | $30 - $338 | 29% |
| Planned Administrators Inc [375] | $30 - $338 | 29% |
| Auto Allstate Insurance [602] | $45 - $344 | 43% |
| Auto American Family Insurance [603] | $45 - $344 | 43% |
| Auto Country Insurance Claims [604] | $45 - $344 | 43% |
| Auto Dairyland Insurance [617] | $45 - $344 | 43% |
| Auto Farmers [605] | $45 - $344 | 43% |
| Auto Geico Claims Oregon [606] | $45 - $344 | 43% |
| Auto Hartford [612] | $45 - $344 | 43% |
| Auto Liberty Mutual Auto Ins [613] | $45 - $344 | 43% |
| Auto Mutual Of Enumclaw [610] | $45 - $344 | 43% |
| Auto Nationwide Allied Insuranc [601] | $45 - $344 | 43% |
| Auto Oregon Mutual [614] | $45 - $344 | 43% |
| Auto Progressive [608] | $45 - $344 | 43% |
| Auto Safeco Concentra [600] | $45 - $344 | 43% |
| Auto State Farm Claims [609] | $45 - $344 | 43% |
| Auto Sublimity Insurance [616] | $45 - $344 | 43% |
| Auto Travelers Insurance [615] | $45 - $344 | 43% |
| Auto Usaa [611] | $45 - $344 | 43% |
| Generic Auto [649] | $45 - $344 | 43% |
| Generic Workers Comp [699] | $45 - $344 | 43% |
| Otj Broadspire Services [670] | $45 - $344 | 43% |
| Otj Ccmsi [618] | $45 - $344 | 43% |
| Otj Chartis Claims [650] | $45 - $344 | 43% |
| Otj City County Ins Services [662] | $45 - $344 | 43% |
| Otj Corvel [676] | $45 - $344 | 43% |
| Otj Esis West Wc Claims [653] | $45 - $344 | 43% |
| Otj Gallagher Bassett [654] | $45 - $344 | 43% |
| Otj Hartford [655] | $45 - $344 | 43% |
| Otj Intermountain Claims Inc [666] | $45 - $344 | 43% |
| Otj Liberty Mutual Wausau Underwriters [671] | $45 - $344 | 43% |
| Otj Penser No American [663] | $45 - $344 | 43% |
| Otj Pinnacle Risk Mgmt [661] | $45 - $344 | 43% |
| Otj Saif [667] | $45 - $344 | 43% |
| Otj Sedgwick Cms [660] | $45 - $344 | 43% |
| Otj Sedgwick [668] | $45 - $344 | 43% |
| Otj Travelers Insurance [672] | $45 - $344 | 43% |
| Otj Tristar [673] | $45 - $344 | 43% |
| Bridgespan [342] | $231 | 223% |
| Asuris Northwest Health [202] | $272 | 262% |
| Healthcare Management Admin [201] | $272 | 262% |
| Regence Group Administrators [203] | $272 | 262% |