CMS Price Transparency Data

Group therapy session

Facility: Texoma Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $167
Cash Discount Price: $446
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Texoma Medical Center is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $446. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.61x the Medicare baseline. Located in 5016 S Us Highway 75, Denison, TX.

Cash / Self-Pay

$446

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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: $446 (430%)

Insurance Median: $167 (161%)

Cash: $446 (430% of Medicare)

Ins. Median: $167 (161% 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
Molina	$44 - $449	42%
Superior	$46 - $57	44%
Tchp	$51 - $57	49%
Amerigroup	$71 - $81	68%
United_Healthcare	$71 - $81	68%
Aetna	$156 - $177	150%
Cigna	$206 - $251	198%
Humana	$325 - $369	313%
Healthsmart	$369 - $475	356%
Multiplan	$395 - $449	381%
Healthchoice	$475	458%

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 $446.
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 Texoma 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.