CMS Price Transparency Data

Group therapy session

Facility: Pennsylvania Hospital

Billing Code: 90853 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$110

about 1.1× the $104 Medicare rate · typically $49–$120

modeled estimate · not a bill or quote

What this hospital charges insurers

$113

About the fair price

about $3 over the fair price · 1.1× Medicare

Medicare pays $104 Fair price $110 This hospital $113 Cash price $158 Hospital's list price $158

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $16 Priciest $113

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Group therapy session is about $110 (about 1.1× the $104 Medicare rate). Pennsylvania Hospital charges insurers about $113, or about $158 in cash — about the fair price. Located in Philadelphia, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$3 - $299	3%
Blue Cross Blue Shieldmajor	$4 - $299	4%
Aetnamajor	$4 - $299	4%
Cignamajor	$5 - $115	5%
Humanamajor	$13 - $239	13%
Clover Health	$115	111%
Geisinger	$109 - $337	105%
Health Net	$9 - $299	9%
HealthPartners	$16 - $299	15%
Oscar Health	$181	174%
UPMC Health Plan	$4 - $299	4%
+ 37 smaller / regional plans	$3 - $299

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 158), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90853.

Insurance Before you use insurance

Call your insurance company to confirm Pennsylvania Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 90853.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Pennsylvania Hospital

Compare: Group therapy session at other PA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.