CMS Price Transparency Data
Group therapy session
Facility: Cannon Memorial Hospital
Billing Code: 90853 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90853
- Insurance Median: $42
- Cash Discount Price: $93
- vs. Medicare Baseline: 0.40x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Cannon Memorial Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.40x the Medicare baseline. Located in 123 W G Acker Drive, Pickens, SC.
Cash / Self-Pay
$93
Average discount available for prompt cash payment at this facility.
Insurance Median
$42
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: $93 (90%)
Insurance Median: $42 (40%)
Cash: $93 (90% of Medicare)
Ins. Median: $42 (40% 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 | $16 - $732 | 15% |
| Absolute Total Care [58] | $17 - $732 | 16% |
| Humana | $17 - $732 | 16% |
| Blue Choice Health Plan [922] | $18 - $218 | 17% |
| Blue Cross Blue Shield | $18 - $361 | 17% |
| Planned Administrators [886] | $18 - $194 | 17% |
| Thomas Cooper & Company [315] | $18 - $194 | 17% |
| Select Health Of Sc [637] | $19 - $697 | 18% |
| Aetna | $23 - $216 | 22% |
| Medicare (plans) | $23 - $380 | 22% |
| UnitedHealthcare | $23 - $380 | 22% |
| Vaccn - Va Community Care Network [16] | $23 | 22% |
| Veterans Administration [633] | $23 | 22% |
| Absolute Total Care Mcr Plans Alt Payer [4101] | $24 | 23% |
| Absolute Total Care Mcr Plans [41] | $24 | 23% |
| Champva [604] | $24 | 23% |
| Cigna | $24 - $380 | 23% |
| Devoted Health Alt Payer [9401] | $24 | 23% |
| Devoted Health [94] | $24 | 23% |
| First Choice Vip Careplus Alt Payer [3301] | $24 | 23% |
| First Choice Vip [33] | $24 | 23% |
| Molina Dual Options Alt Payer [1501] | $24 | 23% |
| Molina Dual Options [15] | $24 | 23% |
| Nhc Advantage Alt Payer [6101] | $24 | 23% |
| Nhc Advantage [61] | $24 | 23% |
| Tricare | $24 | 23% |
| Bright Health Alt Payer [1001] | $25 | 24% |
| Employee Benefit Management Services [869] | $29 - $106 | 28% |
| Bright Health [11] | $32 | 31% |
| Ambetter / Centene | $33 | 32% |
| First Choice Next [96] | $34 | 33% |
| Molina Marketplace [97] | $34 | 33% |
| Preferred Administrators [19] | $36 - $228 | 35% |
| Geha [302] | $37 - $203 | 36% |
| Golden Rule Ins Co [584] | $37 - $203 | 36% |
| Mail Handlers Benefit Plan [327] | $37 - $216 | 36% |
| Rural Carrier Benefit Plan [406] | $37 - $216 | 36% |
| Workers Compensation [622] | $37 | 36% |
| Nalc Health Benefit Plan [291] | $38 - $226 | 37% |
| Edison Health Solutions [95] | $41 | 40% |
| Healthscope [98] | $41 | 40% |
| Medcost [206] | $43 - $342 | 41% |
| Phcs [940] | $53 - $251 | 51% |
| Other Hospital Payers [1991] | $106 - $380 | 102% |
| Coventry Health [245] | $194 - $274 | 187% |
| American Continental Ins [778] | $310 - $380 | 299% |
| American Republic Life Ins [722] | $310 - $380 | 299% |
| Business Office [6000] | $310 - $380 | 299% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [17] | $310 - $380 | 299% |
| First Health [946] | $310 - $380 | 299% |
| Guarantee Trust Life Insurance [236] | $310 - $380 | 299% |
| Home Health Infusion Payer [6001] | $310 - $380 | 299% |
| Manhattan Life Ins Co [932] | $310 - $380 | 299% |
| Miscellaneous Commercial [1] | $310 - $380 | 299% |
| New Era Life Ins Co [437] | $310 - $380 | 299% |
| Non-Contracted [22] | $310 - $380 | 299% |
| Physicians Mutual [773] | $310 - $380 | 299% |
| Reference Based Pricing/Limited Plan [21] | $310 - $380 | 299% |
| State Farm Ins Co [373] | $310 - $380 | 299% |
| Sterling Investors Life [244] | $310 - $380 | 299% |
| Supermed/Med Mutual Of Ohio [539] | $310 - $380 | 299% |
| United American Ins Co [277] | $310 - $380 | 299% |