CMS Price Transparency Data

Group therapy session

Facility: Christus Santa Rosa Hospital-San Marcos

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $92
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Christus Santa Rosa Hospital-San Marcos is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.89x the Medicare baseline. Located in 1301 Wonder World Drive, San Marcos, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$92

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%)
Insurance Median: $92 (89%)
Ins. Median: $92 (89% 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
Allwell $90 87%
Christus Health $90 - $126 87%
Humana $90 - $121 87%
Triwest $90 87%
UnitedHealthcare $90 87%
Washington National $90 87%
Wellcare $90 87%
Aetna $91 88%
Cigna $92 89%
Provider Partners Health Plan $92 89%
Shared Health Insurance Company $94 91%
Amerigroup $97 93%
Devoted Health Plan $97 93%
Sendero $153 147%
Naphcare Inc. $179 172%
Healthcare Highways $227 219%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1301 Wonder World Drive, San Marcos, TX 78666
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals