CMS Price Transparency Data

Group therapy session

Facility: Erlanger Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $37
Cash Discount Price: $30
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Erlanger Medical Center is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.36x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.

Cash / Self-Pay

$30

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $30 (29%)

Insurance Median: $37 (36%)

Cash: $30 (29% of Medicare)

Ins. Median: $37 (36% 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
Humana	$22 - $85	21%
UnitedHealthcare	$22 - $89	21%
Cigna	$26 - $85	25%
Blue Cross Blue Shield	$27 - $85	26%
Bluecare	$28 - $88	27%
Amerigroup	$30 - $70	29%
Caresource	$31 - $170	30%
Peach State Hlth Plan	$31	30%
Alexian	$33 - $85	32%
Bluecard - Network S	$33 - $68	32%
Clover	$33 - $85	32%
Medicare (plans)	$33	32%
Upmc	$33 - $85	32%
Aetna	$34 - $87	33%
American Health	$34 - $87	33%
Bluecard - Network P	$34 - $68	33%
Pruitthealth Premier	$34	33%
Devoted Health	$35 - $88	34%
Nhc	$35 - $89	34%
Atrio Health	$37 - $93	36%
Simpra Advantage	$37	36%
Ambetter / Centene	$42 - $106	40%
Caresource Ga	$49 - $88	47%
Caresource Tn	$49 - $88	47%
Olympus	$50 - $57	48%
Alliant	$53	51%
Pnoa	$57 - $212	55%
Occunet	$58 - $81	56%
Caresource Nc	$59 - $88	57%
Point Comfort Underwriters	$59 - $60	57%

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 $30.
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 Erlanger 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.