CMS Price Transparency Data

Group therapy session

Facility: Baylor Scott & White Medical Center - Marble Falls

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $134
Cash Discount Price: $146
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Baylor Scott & White Medical Center - Marble Falls is $134. 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 1.29x the Medicare baseline. Located in 810 W Highway 71, Marble Falls, TX.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$134

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: $134 (129%)

Cash: $146 (141% of Medicare)

Ins. Median: $134 (129% 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	$44 - $79	42%
Baylor Scott & White Health Plan	$75 - $130	72%
Humana	$79 - $171	76%
Triwest	$79	76%
Corvel	$82	79%
Prime Health Services	$82	79%
American Health Plan	$83	80%
Blue Cross Blue Shield	$83 - $321	80%
Healthspring	$83	80%
Procare Advantage	$83	80%
UnitedHealthcare	$90 - $135	87%
Sedgwick	$118	114%
Cigna	$125 - $147	120%
Aetna	$134 - $229	129%
Midcoast	$134	129%
Quiktrip	$134	129%
University Of Mary Hardin-Baylor	$141	136%
Independent Medical System	$146	141%
Curative	$158	152%
First Health	$171	165%
Healthsmart	$171 - $183	165%
Bluebell Creameries	$183	176%
Private Health Care System	$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 Medical Center - Marble Falls 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.