Group therapy session
Facility: Prisma Health Baptist
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $233
- Cash Discount Price: $176
- vs. Medicare Baseline: 2.24x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 224% of the Medicare baseline (a markup of 124%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 - $155 | 25% |
| UnitedHealthcare | $26 - $649 | 25% |
| 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% |
| Blue Cross Blue Shield | $116 - $464 | 112% |
| Cigna | $118 - $490 | 114% |
| Evernorth Behavioral Contracted [2982] | $118 - $490 | 114% |
| Preferred Administrators Contracted [2839] | $119 - $259 | 115% |
| Medcost [2940] | $126 - $307 | 121% |
| Atlantic Packaging Contracted [4833] | $128 - $278 | 123% |
| Humana | $128 - $278 | 123% |
| Nippon [2300] | $134 - $292 | 129% |
| 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% |
| Carelon Behavioral Health [3180] | $175 - $375 | 169% |
| Scdc-Sc Dept Of Corrections [7232] | $208 - $464 | 200% |
| Bluechoice [810] | $233 - $397 | 224% |
| Golden Rule Insurance Company [2991] | $289 - $649 | 278% |
| Oxford Health Plans [2992] | $289 - $649 | 278% |
| Zzumr-Salt Lake City Ut [3169] | $289 - $649 | 278% |
| Planned Administrators [820] | $398 | 383% |