CMS Price Transparency Data

Group therapy session

Facility: Metro Nashville General Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $23
  • Cash Discount Price: $106
  • vs. Medicare Baseline: 0.22x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Metro Nashville General Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.22x the Medicare baseline. Located in 1818 Albion Street, Nashville, TN.
Cash / Self-Pay
$106

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $106 (102%)
Insurance Median: $23 (22%)
Cash: $106 (102% of Medicare)
Ins. Median: $23 (22% 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
UnitedHealthcare $13 - $23 13%
Corizon $15 14%
Bluecare $19 18%
Tenncare $19 18%
Amerigroup $20 19%
Amerivantage $20 19%
Aetna $23 - $97 22%
Blue $23 22%
Cigna $23 - $25 22%
Farm Bureau $23 22%
Humana $23 22%
Medicare (plans) $23 22%
Upmc $23 22%
Wellcare $23 22%
Corecivic $25 24%
Blue Cross Blue Shield $27 - $35 26%
Ambetter / Centene $32 31%
Naphcare $35 34%
Provider Network Of America $39 38%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1818 Albion Street, Nashville, TN 37208
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals