CMS Price Transparency Data

Group therapy session

Facility: Cumberland Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $70
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 0.67x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Cumberland Medical Center is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.67x the Medicare baseline. Located in 421 S Main St, Crossville, TN.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $35 (34%)
Insurance Median: $70 (67%)
Cash: $35 (34% of Medicare)
Ins. Median: $70 (67% 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
Blue Cross Blue Shield $18 - $95 17%
Aetna $35 - $95 34%
Ehn $39 - $43 38%
UnitedHealthcare $42 - $95 40%
Cigna $44 - $95 42%
Ambetter / Centene $52 - $58 50%
Correctional Medical Services $52 - $58 50%
Community Services Network $57 - $62 55%
Usa Managed Care Organization $61 - $67 59%
Novanet $65 - $72 63%
Direct Care America $70 - $77 67%
Medsave Usa $70 - $77 67%
National Provider Network $70 - $77 67%
Beech Street $74 - $82 71%
Ccn Managed Care $74 - $82 71%
Wellpoint $75 - $95 72%
Initial Group $77 - $84 74%
Galaxy Health Network $78 - $86 75%
Farm Bureau $83 80%
Tricare $90 87%
Humana $93 90%
Devoted Health $95 92%
Wellcare $95 92%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 421 S Main St, Crossville, TN 38555
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals