CMS Price Transparency Data

Group therapy session

Facility: Prisma Health Laurens County Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $170
  • Cash Discount Price: $176
  • vs. Medicare Baseline: 1.64x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Prisma Health Laurens County Hospital is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.64x the Medicare baseline. Located in 22725 Highway 76 East, Clinton, SC.
Cash / Self-Pay
$176

Average discount available for prompt cash payment at this facility.

Insurance Median
$170

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: $176 (170%)
Insurance Median: $170 (164%)
Cash: $176 (170% of Medicare)
Ins. Median: $170 (164% 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 $26 - $188 25%
UnitedHealthcare $26 - $244 25%
Medicare (plans) $30 - $188 29%
Blue Cross Blue Shield $32 - $211 31%
Bluechoice [810] $39 - $223 38%
Prisma Health Seniorcare Pace - Midlands [5400] $39 - $86 38%
Prisma Health Seniorcare Pace-Upstate [5200] $39 - $86 38%
Promise Health Plan Contracted [2401] $60 - $450 58%
Orangeburg Senior Helping Center Pace [5401] $68 - $148 66%
Tricare $86 83%
Bob Jones Univ-Pai [821] $102 - $375 98%
Aetna $109 - $292 105%
Meritain Health Contracted [2200] $109 - $292 105%
Cigna $118 - $490 114%
Evernorth Behavioral Contracted [2982] $118 - $490 114%
Mvp Health Care [3037] $118 - $490 114%
Preferred Administrators Contracted [2839] $119 - $259 115%
Medcost [2940] $126 - $307 121%
Atlantic Packaging Contracted [4833] $128 - $278 123%
Aps Healthcare System [2981] $136 - $296 131%
Multiplan/Phcs Contracted [2950] $151 - $329 145%
Vsp Vision Care [2986] $153 - $333 147%
First Health Contracted [2952] $158 - $344 152%
Furman Int/Allen University Student [2951] $158 - $344 152%
Quiktrip-First Health [3067] $158 - $344 152%
Companion Benefit Alternatives [2983] $162 - $351 156%
Humana $170 164%
Carelon Behavioral Health [3180] $175 - $375 169%
First Choice Benefits Mgmt [3074] $188 181%
Sc Dept Of Corrections [2998] $208 200%
Scdc-Sc Dept Of Corrections [7232] $208 200%
Planned Administrators [820] $211 203%
Golden Rule Insurance Company [2991] $244 235%
Oxford Health Plans [2992] $244 235%
Zzumr-Salt Lake City Ut [3169] $244 235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 22725 Highway 76 East, Clinton, SC 29325
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals