Group therapy session
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $86
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.83x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $25 - $240 | 24% |
| Aetna | $26 | 25% |
| Medicaid / KanCare | $26 | 25% |
| Blue Cross Blue Shield | $32 - $34 | 31% |
| Providrs Care | $33 | 32% |
| Tricare | $61 | 59% |
| Va | $86 | 83% |
| Humana | $86 | 83% |
| Medicare (plans) | $86 - $87 | 83% |
| Smarthealth | $120 | 116% |
| Ambetter / Centene | $145 | 140% |
Consumer Guidance & Cost Commentary
For CPT code 90853, a group therapy session at Ascension Via Christi Hospital Manhattan, Inc, the facility's negotiated rates range from $25 to $145 depending on the insurance plan. The lowest negotiated rate of $25 comes from UnitedHealthcare, while the highest is $145 from Ambetter/Centene. This facility is located in Manhattan, Kansas, and its pricing structure is significantly lower than the state average for this service. While the data does not provide a specific cash or median paid amount, patients with high-deductible plans should be aware that paying cash upfront might result in a lower total cost than what their insurance would negotiate, as commercial rates often include administrative overhead that exceeds the true cost of care.
To minimize unexpected costs, patients should verify their specific plan's allowed amount before scheduling, as in-network rates vary widely by carrier. If a patient chooses to pay out-of-pocket, they should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% for upfront payment. Additionally, if a balance bill arises from an out-of-network provider or service, patients should not pay immediately; instead, they should request an itemized audit to identify errors or dispute the charge under the No Surprises Act. Comparing the facility's rates to the Medicare benchmark of $103.79 reveals that while some commercial plans pay significantly less, others approach or exceed the Medicare rate, highlighting the importance of checking individual plan details rather than relying on general averages.