CMS Price Transparency Data

Group therapy session

Facility: Henrico Doctors' Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $166
Cash Discount Price: $502
vs. Medicare Baseline: 1.60x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Henrico Doctors' Hospital is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $502. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.60x the Medicare baseline. Located in 1602 Skipwith Road, Richmond, VA.

Cash / Self-Pay

$502

Average discount available for prompt cash payment at this facility.

Insurance Median

$166

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: $502 (484%)

Insurance Median: $166 (160%)

Cash: $502 (484% of Medicare)

Ins. Median: $166 (160% 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
Cigna	$72 - $105	69%
Bright Health	$81	78%
Oscar	$85	82%
Lifeworks	$95	92%
United	$104 - $226	100%
Universal Healthcare Group	$110	106%
Aetna	$161 - $166	155%
Virginia Health Network	$176 - $326	170%
Greenvbrier Sporting Club	$301	290%
Corvel	$361	348%
Occunet Workers Comp	$402	387%
4Most Health Nework	$452	435%
Multiplan	$452	435%

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 $502.
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 Henrico Doctors' 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.