CMS Price Transparency Data

Group therapy session

Facility: Memorial Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $35
  • Cash Discount Price: $124
  • vs. Medicare Baseline: 0.34x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Memorial Medical Center is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $124. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.34x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$124

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $124 (119%)
Insurance Median: $35 (34%)
Cash: $124 (119% of Medicare)
Ins. Median: $35 (34% 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
Ambetter / Centene $8 - $110 8%
Healthcare Highways-All Plans $17 - $262 16%
Prime Healthcare Services-All Plans $18 - $230 17%
Blue Cross Blue Shield $19 - $21 18%
Humana $21 - $262 20%
Corvel Work Comp-All Plans $22 - $279 21%
Independent Med Sys Ppo-All Plans $22 - $279 21%
Multiplan Mcr Adv $22 - $92 21%
Multiplan Phcs Ppo-All Other Plans $22 - $279 21%
Provider Select Ppo-All Plans $22 - $279 21%
Three Rivers Ppo-All Plans $22 - $279 21%
Usa Mso - All Plans $22 - $279 21%
Amerigroup Mcr Adv-All Other Plans $24 - $92 23%
Care Improvement Plus - All Other Plans $24 - $92 23%
Care Improvement Plus Mcr $24 - $93 23%
Superior Allwell Mcr Adv-All Other Plans $24 - $92 23%
Triwest Va Pccc-All Plans $24 - $90 23%
UnitedHealthcare $24 - $49 23%
Universal American Mcr-All Other Plans $24 - $92 23%
Universal American Snp $25 - $96 24%
Amerigroup Chip $26 - $157 25%
Amerigroup Star $26 - $157 25%
Amerigroup Star Kids $26 - $157 25%
Amerigroup Star Plus $26 - $157 25%
Comm Health Chip $26 - $157 25%
Comm Health Perinatal-All Other Plans $26 - $157 25%
Molina Chip/Star-All Plans $26 - $157 25%
Scott & White Chip/Star-All Plans $26 - $157 25%
Superior Chip/Star $26 - $157 25%
Texas Childrens Hp - All Plans $26 - $157 25%
Comm Health Mcaid Hmo $27 - $165 26%
Comm Health Star $27 - $165 26%
Coventry First Hlth Hmo Ppo-All Other Plans $30 - $262 29%
Coventry First Hlth Mcr Adv $30 - $92 29%
Galaxy Health Network-All Plans $35 - $279 34%
Capstar Health Network-All Plans $40 - $262 39%
Cigna $40 - $246 39%
Aetna $262 252%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals