CMS Price Transparency Data

Group therapy session

Facility: Baylor Scott & White Continuing Care Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $158
Cash Discount Price: $146
vs. Medicare Baseline: 1.52x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Baylor Scott & White Continuing Care Hospital is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.52x the Medicare baseline. Located in 546 N Kegley Rd, Temple, TX.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$158

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: $146 (141%)

Insurance Median: $158 (152%)

Cash: $146 (141% of Medicare)

Ins. Median: $158 (152% 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
Superior Health Plan	$76	73%
Corvel	$84	81%
Injury Management Organization	$100	96%
Careworks Fka Rockport	$121	117%
Sedgwick	$121	117%
UnitedHealthcare	$122 - $171	118%
Midcoast	$134	129%
Blue Cross Blue Shield	$136 - $166	131%
Independent Medical System	$146	141%
Cigna	$156 - $183	150%
Curative	$158	152%
First Health	$171	165%
Healthsmart	$171 - $183	165%
Humana	$171	165%
Imagine Health	$175	169%
Aetna	$183	176%
University Of Mary Hardin-Baylor	$183	176%
Three Rivers	$219	211%

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 $146.
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 Continuing Care Hospital 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.