CMS Price Transparency Data

Group therapy session

Facility: Monument Health Rapid City Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $190
Cash Discount Price: $229
vs. Medicare Baseline: 1.83x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Monument Health Rapid City Hospital is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $229. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.83x the Medicare baseline. Located in 353 Fairmont Blvd, Rapid City, SD.

Cash / Self-Pay

$229

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

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: $229 (221%)

Insurance Median: $190 (183%)

Cash: $229 (221% of Medicare)

Ins. Median: $190 (183% 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
Risk Admin Svs [3081167]	$22	21%
Tricare	$64 - $91	62%
Minnesota Health Care Programs 12K16 [3081295]	$69	66%
Healthpartners [3081368]	$91	88%
Health Partners Sx009 [3081102]	$142	137%
Blue Cross Blue Shield	$149	144%
Coresource 38225 [3081146]	$149 - $156	144%
Avera Health Plans 46045 [3081018]	$168	162%
Rocky Mountain Admin Llc 83028 [3081168]	$183	176%
Medica (Commercial) 94265 [3081118]	$190	183%
Employee Benefit Management 12X44 [3081079]	$195	188%
Pacificsource Health Plans [3081333]	$195	188%
Aetna	$206	198%
Group And Pension Administrators Inc [3081098]	$206	198%
Humana	$206	198%
Multiplan Inc 34080 [3081285]	$206	198%
Sanford Health Plan 91184 [3081174]	$206	198%
Tlc Advantage Llc [3081189]	$215	207%
Fedmed Inc [3081283]	$218	210%
Allied Benefit Systems Inc [3081320]	$220	212%
Cigna	$220	212%
Key Benefit Administrators [3081332]	$220	212%
Meritain Health [3081135]	$220	212%
Midlands Choice 47080 [3081136]	$220	212%
Preferred One 41147 [3081160]	$220	212%

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 $229.
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 Monument Health Rapid City Hospital 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.