CMS Price Transparency Data

Group therapy session

Facility: Swedish Issaquah

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $205
Cash Discount Price: $210
vs. Medicare Baseline: 1.98x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Swedish Issaquah is $205. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $210. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.98x the Medicare baseline. Located in 751 Ne Blakely Dr, Issaquah, WA.

Cash / Self-Pay

$210

Average discount available for prompt cash payment at this facility.

Insurance Median

$205

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: $210 (202%)

Insurance Median: $205 (198%)

Cash: $210 (202% of Medicare)

Ins. Median: $205 (198% 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
Kaiser	$118 - $177	114%
Aetna	$122 - $123	118%
UnitedHealthcare	$124 - $500	119%
Humana	$125	120%
Blue Shield	$127 - $237	122%
Amerigroup	$130	125%
Cigna	$142	137%
Community Health Plan	$189	182%
Blue Cross Blue Shield	$197 - $238	190%
Coordinated Care	$218	210%
Providence Health Plan	$262	252%
First Choice	$369 - $393	356%

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 $210.
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 Swedish Issaquah 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.