Group therapy session
Facility: Greeley County Health Services
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $38
- Cash Discount Price: $53
- vs. Medicare Baseline: 0.37x 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 |
|---|---|---|
| Blue Cross Blue Shield | $38 | 37% |
Consumer Guidance & Cost Commentary
For this CPT code representing a group therapy session at Greeley County Health Services in Tribune, Kansas, the facility's cash median price is $53.00, which is lower than the state average of $76.00. While the facility's negotiated rate with Blue Cross Blue Shield is $38.00, patients should note that cash payments can sometimes be more cost-effective if their insurance plan has a high deductible or if the negotiated rate exceeds the cash price. Since this is a Critical Access Hospital with government local ownership, it is advisable to contact the billing department directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can further reduce the final amount owed.
To ensure you are not overcharged, it is important to understand that commercial negotiated rates often include administrative overhead and can be higher than the actual cost of care, which is reflected in the Medicare benchmark of $103.79 for this service. Although the Medicare amount appears higher than the cash price, commercial contracts are not bound by these federal rates, and the $38.00 negotiated rate represents the specific contract ceiling with the insurer. If you receive a bill that exceeds these figures, you should request a full itemized audit to verify that no unbundled codes or services not rendered have been included, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.