CMS Price Transparency Data

Group therapy session

Facility: Klickitat Valley Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $144
Cash Discount Price: $97
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Klickitat Valley Hospital is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.39x the Medicare baseline. Located in 310 South Roosevelt, Goldendale, WA.

Cash / Self-Pay

$97

Average discount available for prompt cash payment at this facility.

Insurance Median

$144

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: $97 (93%)

Insurance Median: $144 (139%)

Cash: $97 (93% of Medicare)

Ins. Median: $144 (139% 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
United Behavioral Health	$42	40%
Molina	$90 - $182	87%
Community Health Plan Of Wa	$91	88%
Coordinated Care	$91	88%
Pacificsource Health Plans	$91 - $306	88%
UnitedHealthcare	$94 - $147	91%
Wellpoint	$97 - $385	93%
Cigna	$141	136%
Health Net Health Plan Of Oregon	$192	185%
Moda Health Plan	$192	185%
Providence Health Plan	$192	185%
Ambetter / Centene	$306	295%
Regence Blueshield	$306	295%

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 $97.
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 Klickitat Valley 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.