CMS Price Transparency Data

Group therapy session

Facility: Children's Hospital of Philadelphia

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $79
  • Cash Discount Price: $261
  • vs. Medicare Baseline: 0.76x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Children's Hospital of Philadelphia is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $261. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.76x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.
Cash / Self-Pay
$261

Average discount available for prompt cash payment at this facility.

Insurance Median
$79

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: $261 (251%)
Insurance Median: $79 (76%)
Cash: $261 (251% of Medicare)
Ins. Median: $79 (76% 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.

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
Medicaid / KanCare $17 - $69 16%
UnitedHealthcare $17 - $230 16%
Health Partners $20 - $79 19%
Aetna $27 - $209 26%
Highmark Wholecare $28 - $114 27%
Upmc Medical Assistance $28 - $114 27%
Horizon Nj Health $31 30%
Keystone First Chip $32 - $129 31%
Keystone Health Plan East $33 - $132 32%
Blue Cross Blue Shield $37 - $167 36%
Geisinger Medical Assistance $42 - $167 40%
Geisinger Health Plan Commercial $46 - $184 44%
Jefferson Health Plans $49 - $198 47%
Cigna $52 - $209 50%
Highmark $52 - $209 50%
Qualcare $57 - $230 55%
First Health Network $68 - $271 66%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics $84 - $334 81%
Private Health Care Systems $84 - $334 81%
Choice Care Network $94 - $376 91%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3401 Civic Center Blvd, Philadelphia, PA 19104
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens