CMS Price Transparency Data

Group therapy session

Facility: Aurora Medical Ctr Oshkosh

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $207
  • Cash Discount Price: $150
  • vs. Medicare Baseline: 1.99x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Aurora Medical Ctr Oshkosh is $207. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.99x the Medicare baseline. Located in 855 N Westhaven Drive, Oshkosh, WI.
Cash / Self-Pay
$150

Average discount available for prompt cash payment at this facility.

Insurance Median
$207

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: $150 (145%)
Insurance Median: $207 (199%)
Cash: $150 (145% of Medicare)
Ins. Median: $207 (199% 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.

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
Everpointe Elite $122 - $178 118%
Hs Technology $122 - $178 118%
Aetna $131 - $293 126%
Quartz One $135 - $195 130%
UnitedHealthcare $146 - $299 141%
Aurora Caregiver $147 - $213 142%
Blue Cross Blue Shield $147 - $302 142%
Common Ground $147 - $213 142%
Health Eos Plus $147 - $213 142%
Healthpartners $147 - $266 142%
Molina Exchange $147 - $213 142%
Quartz Group $147 - $213 142%
Wisconsin Physician Service $152 - $231 146%
Health Payment Systems $159 - $231 153%
Trilogy $172 - $248 166%
Centivo $184 - $266 177%
Cigna $184 - $300 177%
Health Eos $196 - $284 189%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 855 N Westhaven Drive, Oshkosh, WI 54904
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals