CMS Price Transparency Data

Group therapy session

Facility: Medical Center of McKinney

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $349
Cash Discount Price: $935
vs. Medicare Baseline: 3.36x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Medical Center of McKinney is $349. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $935. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 3.36x the Medicare baseline. Located in 4500 Medical Center Drive, McKinney, TX.

Cash / Self-Pay

$935

Average discount available for prompt cash payment at this facility.

Insurance Median

$349

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: $935 (901%)

Insurance Median: $349 (336%)

Cash: $935 (901% of Medicare)

Ins. Median: $349 (336% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 336% of the Medicare baseline (a markup of 236%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$10 - $608	10%
Superior Health Plan	$65	63%
Aetna	$126 - $680	121%
Cigna	$126 - $349	121%
United	$175	169%
Oscar	$195	188%
Evry Health	$241	232%
Unicare	$243 - $935	234%
Healthcare Highways	$316	304%
City Of Mckinney	$327	315%
Blue Cross Blue Shield	$415	400%
Fidelis Securecare	$421	406%
National Choicecare	$468	451%
Pc Texas Partners	$514	495%
Physicians Coop Of Tx	$514	495%
Rockport Health Group	$514	495%
Averde Health, Inc	$542	522%
Magellan Bh	$561	541%
Value Options Behavioral Health	$561	541%
Coastal Comp Health Networks	$655	631%
Mega Life	$655	631%
Multiplan Phcs	$655	631%
Lewisville Isd/Dls Consulting	$701	675%
Healthsmart Preferred Care	$748	721%
Usa Managed Care	$748	721%
Galaxy Health Network	$795	766%
Independent Medical Systems	$935	901%
National Healthcare Solutions	$935	901%

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 $935.
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 Medical Center of McKinney 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.