CMS Price Transparency Data

Group therapy session

Facility: Bellin Health Oconto Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $200
  • Cash Discount Price: $174
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Bellin Health Oconto Hospital is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.93x the Medicare baseline. Located in 820 Arbutus Ave, Oconto, WI.
Cash / Self-Pay
$174

Average discount available for prompt cash payment at this facility.

Insurance Median
$200

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: $174 (168%)
Insurance Median: $200 (193%)
Cash: $174 (168% of Medicare)
Ins. Median: $200 (193% 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
Blue Cross Blue Shield $91 - $220 88%
Community Care $91 88%
Humana $91 88%
My Choice $91 88%
Network Health $91 - $227 88%
UnitedHealthcare $109 - $187 105%
Aetna $134 129%
Cigna $189 - $192 182%
Common Ground $194 - $200 187%
Chorus Community Health Plan $200 193%
Aspirus Arise $209 201%
Healthsmart $214 206%
Ihs(Claimsbridge) $214 206%
Medical College Of Wi $214 206%
Hps/Paymedix $219 - $238 211%
Wps Insurance $224 216%
Allied National $227 219%
First Health $227 219%
Galaxy Health $227 219%
Three Rivers Provider Network $240 231%
Trilogy $240 231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 820 Arbutus Ave, Oconto, WI 54153
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals