CMS Price Transparency Data

Group therapy session

Facility: Geisinger-Lewistown Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $116
Cash Discount Price: $150
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Geisinger-Lewistown Hospital is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.12x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $150 (145%)

Insurance Median: $116 (112%)

Cash: $150 (145% of Medicare)

Ins. Median: $116 (112% 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
Amerihealth	$4	4%
Geisinger Family Plan	$4	4%
Health Partners	$4	4%
Medicaid / KanCare	$4	4%
Upmc Chip	$4	4%
Upmc Health Plan	$4 - $11,890	4%
Preferential Care Network	$25	24%
Blue Cross Blue Shield	$79 - $271	76%
Geisinger Health Plan	$90 - $420	87%
Medicare (plans)	$90	87%
Advantra	$91	88%
Humana	$91	88%
Aetna	$99 - $118	95%
Cigna	$100 - $127	96%
UnitedHealthcare	$107	103%
Christian Healthcare Ministries	$121	117%
Christian Health Aid	$194	187%
Three Rivers Provider Network Inc.	$194	187%
Multiplan	$206	198%
Ambetter / Centene	$215	207%
Healthsmart Payors Organization	$218	210%
Mhnet	$342	330%

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 $150.
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 Geisinger-Lewistown 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.