CMS Price Transparency Data

Group therapy session

Facility: Trident Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $756
Cash Discount Price: $1,944
vs. Medicare Baseline: 7.28x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Trident Medical Center is $756. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,944. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 7.28x the Medicare baseline. Located in 9330 Medical Plaza Dr, Charleston, SC.

Cash / Self-Pay

$1,944

Average discount available for prompt cash payment at this facility.

Insurance Median

$756

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: $1,944 (1873%)

Insurance Median: $756 (728%)

Cash: $1,944 (1873% of Medicare)

Ins. Median: $756 (728% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 728% of the Medicare baseline (a markup of 628%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Absolute Total Care	$79 - $932	76%
Molina	$98 - $932	94%
Nhc Advantage	$103 - $984	99%
Pruitt Health	$103 - $984	99%
Aetna	$115 - $2,450	111%
Medcost	$207 - $2,911	199%
Blue Choice Health Plan	$208	200%
Blue Cross Blue Shield	$208 - $4,921	200%
Sc State Employees	$208	200%
Select Health	$233 - $2,227	224%
Employers Health Network	$244 - $2,331	235%
Occunet	$271 - $2,590	261%
Vocational Rehab	$293 - $2,797	282%
Humana	$352 - $3,885	339%
First Health	$396 - $3,781	382%
Multiplan	$461 - $4,403	444%
Prime Health	$461 - $4,403	444%
Novanet	$488 - $4,662	470%
Evernorth	$1,038 - $4,144	1000%

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 $1,944.
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 Trident 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.