CMS Price Transparency Data

Group therapy session

Facility: Univ. of Vermont - Fletcher Allen Health Care

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $57
Cash Discount Price: $75
vs. Medicare Baseline: 0.55x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Univ. of Vermont - Fletcher Allen Health Care is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.55x the Medicare baseline. Located in 111 Colchester Ave, Burlington, VT.

Cash / Self-Pay

$75

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $75 (72%)

Insurance Median: $57 (55%)

Cash: $75 (72% of Medicare)

Ins. Median: $57 (55% 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
UnitedHealthcare	$19 - $119	18%
Blue Cross Blue Shield	$21 - $95	20%
Humana	$21 - $93	20%
Mvp	$23 - $118	22%
Aetna	$24 - $93	23%
St. Regis	$24 - $93	23%
Veterans Affairs Community Care Network	$24 - $93	23%
Capital District Physicians' Health Plan	$28 - $93	27%
Fidelis Care	$28 - $129	27%
Martins Point	$28 - $96	27%
Wellpath	$34 - $140	33%
Cigna	$35 - $712	34%
Ebpa	$58 - $64	56%
Harvard Pilgrim	$60	58%
Magnacare	$60	58%
Coventry	$64	62%
Nppn	$68	66%

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 $75.
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 Univ. of Vermont - Fletcher Allen Health Care 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.