CMS Price Transparency Data

Group therapy session

Facility: UPMC Williamsport

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $668
Cash Discount Price: $743
vs. Medicare Baseline: 6.44x Medicare

The contracted insurance negotiated median rate for a Group therapy session at UPMC Williamsport is $668. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $743. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 6.44x the Medicare baseline. Located in 700 High Street, Williamsport, PA.

Cash / Self-Pay

$743

Average discount available for prompt cash payment at this facility.

Insurance Median

$668

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: $743 (716%)

Insurance Median: $668 (644%)

Cash: $743 (716% of Medicare)

Ins. Median: $668 (644% 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 644% of the Medicare baseline (a markup of 544%). 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
UnitedHealthcare	$38	37%
Upmc Work Partners	$68	66%
Three Rivers Provider Network	$73 - $1,114	70%
Multiplan	$76 - $966	73%
Blue Cross Blue Shield	$89 - $580	86%
Upmc Health Plan	$90 - $540	87%
Aetna	$91 - $817	88%
Amerihealth Caritas	$91	88%
Highmark Wholecare (Prev Gateway)	$95	92%
Pa Health & Wellness	$95 - $681	92%
Coventry/First Health	$620 - $833	597%
Wirerope Works	$688	663%
Geisinger	$829	799%
Cigna	$848	817%
America'S Choice	$990	954%
Intergroup	$990	954%

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 $743.
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 UPMC Williamsport 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.