CMS Price Transparency Data

Group therapy session

Facility: Island Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $46
Cash Discount Price: $55
vs. Medicare Baseline: 0.44x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Island Hospital is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.44x the Medicare baseline. Located in 1211 24Th Street, Anacortes, WA.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

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: $55 (53%)

Insurance Median: $46 (44%)

Cash: $55 (53% of Medicare)

Ins. Median: $46 (44% 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
Aarp Mcr Adv - All Plans	$19 - $58	18%
Amerigroup Mcaid - All Plans	$19 - $151	18%
Samish Indian Health - All Plans	$19 - $58	18%
UnitedHealthcare	$19 - $58	18%
Chpw Mcaid - All Plans	$20 - $173	19%
Premera Mcr Adv	$20 - $61	19%
Regence Mcr Adv	$20 - $61	19%
Kaiser Comm - All Other Plans	$21 - $32	20%
Premera Comm - All Other Plans	$28 - $34	27%
Cigna	$30 - $120	29%
First Health - All Plans	$31 - $128	30%
First Choice - All Plans	$33 - $128	32%
Regence Comm - All Other Plans	$35 - $112	34%
Coordinated Care Mcaid - All Plans	$37 - $166	36%
Humana	$37 - $128	36%
Kaiser Mcr Adv	$37 - $58	36%
Molina Mcaid - All Plans	$37 - $144	36%
Swinomish Indian Health - All Plans	$37 - $58	36%
Tricare	$37 - $58	36%
Aetna	$39 - $142	38%
Multiplan - All Plans	$40 - $128	39%

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 $55.
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 Island 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.