CMS Price Transparency Data

Group therapy session

Facility: Holy Cross Hospital - Salt Lake

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $168
Cash Discount Price: $132
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Holy Cross Hospital - Salt Lake is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.62x the Medicare baseline. Located in 1050 East South Temple, Salt Lake City, UT.

Cash / Self-Pay

$132

Average discount available for prompt cash payment at this facility.

Insurance Median

$168

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: $132 (127%)

Insurance Median: $168 (162%)

Cash: $132 (127% of Medicare)

Ins. Median: $168 (162% 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
Denver Health	$20	19%
Health Choice	$20	19%
Medicaid / KanCare	$20	19%
Rocky Mountain Health Plan	$20	19%
Uuhp	$20 - $179	19%
Humana	$24	23%
Medicare (plans)	$24	23%
Employer Direct Healthcare	$30	29%
Motivhealth	$31	30%
Molina	$50 - $142	48%
Blue Cross Blue Shield	$100 - $199	96%
Cigna	$118 - $265	114%
Pehp	$141 - $331	136%
Aetna	$146 - $280	141%
Centura Employee Plan	$165	159%
Wise	$172 - $175	166%
Deseret Mutual Benefit Administrators	$203	196%
Select Health	$219	211%
Multiplan	$228 - $301	220%
Emi Health	$331	319%

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 $132.
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 Holy Cross Hospital - Salt Lake 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.