CMS Price Transparency Data

Group therapy session

Facility: Baylor Scott & White Medical Center -Taylor

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $89
Cash Discount Price: $97
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Baylor Scott & White Medical Center -Taylor is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.86x the Medicare baseline. Located in 305 Mallard, Taylor, TX.

Cash / Self-Pay

$97

Average discount available for prompt cash payment at this facility.

Insurance Median

$89

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: $97 (93%)

Insurance Median: $89 (86%)

Cash: $97 (93% of Medicare)

Ins. Median: $89 (86% 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
Baylor Scott & White Health Plan	$32 - $69	31%
Triwest	$34	33%
American Health Plan	$36	35%
Blue Cross Blue Shield	$36 - $321	35%
Corvel	$36	35%
Healthspring	$36	35%
Prime Health Services	$36	35%
Procare Advantage	$36	35%
Superior Health Plan	$36	35%
Careworks Fka Rockport	$42	40%
Injury Management Organization	$42	40%
Sedgwick	$42	40%
UnitedHealthcare	$80 - $90	77%
Cigna	$83 - $98	80%
Aetna	$89 - $229	86%
Midcoast	$89	86%
Quiktrip	$89	86%
University Of Mary Hardin-Baylor	$94	91%
Independent Medical System	$97	93%
Curative	$106	102%
Humana	$106 - $114	102%
First Health	$114	110%
Healthsmart	$114 - $122	110%
Private Health Care System	$122	118%
Bluebell Creameries	$130	125%
Three Rivers	$130	125%

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 $97.
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 Baylor Scott & White Medical Center -Taylor 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.