CMS Price Transparency Data

Group therapy session

Facility: Baylor Scott and White Medical Center McKinney

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $182
Cash Discount Price: $402
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Baylor Scott and White Medical Center McKinney is $182. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $402. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.75x the Medicare baseline. Located in 5252 West University Drive, Mc Kinney, TX.

Cash / Self-Pay

$402

Average discount available for prompt cash payment at this facility.

Insurance Median

$182

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: $402 (387%)

Insurance Median: $182 (175%)

Cash: $402 (387% of Medicare)

Ins. Median: $182 (175% 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	$38 - $150	37%
Baylor Scott & White Health Plan	$77 - $622	74%
Aetna	$82 - $456	79%
Humana	$82 - $750	79%
Triwest	$82	79%
Corvel	$85	82%
Prime Health Services	$85	82%
American Health Plan	$86	83%
Blue Cross Blue Shield	$86 - $515	83%
Healthspring	$86	83%
Procare Advantage	$86	83%
Cigna	$132 - $622	127%
Employers Health Network	$147 - $590	142%
Quiktrip	$147 - $590	142%
University Of Mary Hardin-Baylor	$155 - $622	149%
UnitedHealthcare	$167 - $185	161%
Imagine Health	$168 - $672	162%
Ambetter / Centene	$169	163%
Curative	$174 - $697	168%
First Health	$188 - $750	181%
Healthsmart	$188 - $804	181%
Private Health Care System	$201 - $804	194%

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 $402.
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 and White Medical Center 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.