CMS Price Transparency Data

Group therapy session

Facility: HCA Houston Healthcare Tomball

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $63
Cash Discount Price: $246
vs. Medicare Baseline: 0.61x Medicare

The contracted insurance negotiated median rate for a Group therapy session at HCA Houston Healthcare Tomball is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $246. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.61x the Medicare baseline. Located in 605 Holderrieth, Tomball, TX.

Cash / Self-Pay

$246

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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: $246 (237%)

Insurance Median: $63 (61%)

Cash: $246 (237% of Medicare)

Ins. Median: $63 (61% 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	$13	13%
Superior Health Plan	$15	14%
Community Health Choice Mcd	$32	31%
Cigna	$36 - $47	35%
United	$41 - $111	40%
Oscar	$48	46%
Aetna	$55 - $90	53%
Healthcare Highways	$63	61%
Evry Health	$67	65%
Blue Cross Blue Shield	$86	83%
Coventry National First Health	$89	86%
Christus (Usfhp)	$98	94%

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 $246.
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 HCA Houston Healthcare Tomball 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.