CMS Price Transparency Data

Group therapy session

Facility: Grand Strand Regional Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $171
Cash Discount Price: $311
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Grand Strand Regional Medical Center is $171. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $311. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.65x the Medicare baseline. Located in 809 82Nd Parkway, Myrtle Beach, SC.

Cash / Self-Pay

$311

Average discount available for prompt cash payment at this facility.

Insurance Median

$171

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: $311 (300%)

Insurance Median: $171 (165%)

Cash: $311 (300% of Medicare)

Ins. Median: $171 (165% 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
Absolute Total Care	$45 - $56	43%
Cigna	$49 - $100	47%
Molina	$56	54%
Nhc Advantage	$59	57%
Pruitt Health	$59	57%
Aetna	$89 - $148	86%
Select Health	$134	129%
Medcost	$156 - $212	150%
Occunet	$156	150%
Vocational Rehab	$168	162%
Employers Health Network	$171	165%
Blue Choice Health Plan	$202	195%
Blue Cross Blue Shield	$202 - $410	195%
Sc State Employees	$208	200%
First Health	$257	248%
Global Excel Management	$258	249%
Humana	$264	254%
Multiplan	$264	254%
National Choicecare	$264	254%
Prime Health	$264	254%
Novanet	$280	270%

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 $311.
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 Grand Strand Regional 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.