CMS Price Transparency Data

Group therapy session

Facility: Geisinger Wyoming Valley Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $106
Cash Discount Price: $148
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Geisinger Wyoming Valley Medical Center is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $148. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.02x the Medicare baseline. Located in 1000 East Mountain Boulevard, Wilkes Barre, PA.

Cash / Self-Pay

$148

Average discount available for prompt cash payment at this facility.

Insurance Median

$106

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: $148 (143%)

Insurance Median: $106 (102%)

Cash: $148 (143% of Medicare)

Ins. Median: $106 (102% 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 For You	$4	4%
Blue Cross Blue Shield	$39 - $92	38%
Geisinger Health Plan	$91 - $280	88%
Humana	$91	88%
Life Geisinger	$91	88%
Medicare (plans)	$91 - $103	88%
Prison Health Services	$91	88%
Cigna	$103 - $108	99%
Aetna	$111 - $159	107%
Christian Healthcare Ministries	$119	115%
UnitedHealthcare	$122	118%
Wyoming Seminary	$167	161%
Intergroup Services	$202	195%
Multiplan	$202	195%
Ambetter / Centene	$302	291%

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 $148.
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 Wyoming Valley Medical Center 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.