CMS Price Transparency Data

Group therapy session

Facility: Crossing Rivers Health Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $24
Cash Discount Price: $41
vs. Medicare Baseline: 0.23x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Crossing Rivers Health Medical Center is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.23x the Medicare baseline. Located in 37868 Us Hwy 18, Prairie Du Chien, WI.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$24

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: $41 (40%)

Insurance Median: $24 (23%)

Cash: $41 (40% of Medicare)

Ins. Median: $24 (23% 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
Amerigroup Mcr Adv	$7 - $24	7%
Blue Cross Blue Shield	$7 - $52	7%
Humana	$7 - $24	7%
Security Hlth Mcr Adv	$7 - $24	7%
UnitedHealthcare	$7 - $24	7%
Quartz - All Plans	$13 - $49	13%
Dean Health Plan - All Plans	$15 - $62	14%
Health Trad Hp - All Plans	$15 - $62	14%
Medica Hp Solutions	$15	14%
Security Hlth Comm - All Other Plans	$15 - $24	14%
Wea Provider Ntwrk - All Plans	$15	14%
Cigna	$16 - $63	15%
First Health - All Plans	$16 - $63	15%
Geha - All Plans	$16 - $63	15%
Group Health Co-Op - All Plans	$16 - $52	15%
Health Partners - All Plans	$16 - $63	15%
Medical Associates Hp - All Plans	$16 - $63	15%
Preferred Health Choice - All Plans	$16	15%
Wps - All Plans	$16 - $41	15%
Amerigroup Mcaid-All Other Plans	$65 - $516	63%
Iowa Total Care Mcaid-All Plans	$65 - $516	63%

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 $41.
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 Crossing Rivers Health Medical Center 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.