Group therapy session
Facility: Ann & Robert H Lurie Childrens Hospital of Chicago
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $279
- Cash Discount Price: $244
- vs. Medicare Baseline: 2.69x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 269% of the Medicare baseline (a markup of 169%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Psychealth Ltd | $34 | 33% |
| Beacon Health Options | $35 | 34% |
| Aetna | $45 - $185 | 43% |
| Magellan | $55 - $900 | 53% |
| Medicare (plans) | $59 - $2,656 | 57% |
| Cigna | $124 - $248 | 119% |
| Mercycare Health | $129 | 124% |
| Blue Cross Blue Shield | $151 - $279 | 145% |
| La Rabida Childrens Hospital | $174 | 168% |
| Centegra | $209 | 201% |
| Independent Physicians at Mercy | $209 | 201% |
| Presence Health Partners | $244 | 235% |
| West Suburban Health Providers | $244 | 235% |
| Advanced Physicians Association IPA | $244 | 235% |
| Health Plus | $244 | 235% |
| Ui Health | $244 | 235% |
| Methodist First Choice | $244 | 235% |
| St. Francis | $244 | 235% |
| Imagine Health | $244 | 235% |
| Northwest Community Healthcare | $244 | 235% |
| Shriners Hospital | $262 | 252% |
| Swedish Covenant Physician Partners | $262 | 252% |
| Health Alliance | $279 | 269% |
| Macneal Health | $279 | 269% |
| American Psych Systems | $279 | 269% |
| Healthlink Inc. | $288 | 277% |
| Hfn Inc | $297 - $314 | 286% |
| Humana | $297 | 286% |
| St. Elizabeth | $297 | 286% |
| Principal Healthcare | $297 | 286% |
| Cofinity | $297 | 286% |
| First Health | $307 | 296% |
| Sagamore Health Network | $307 | 296% |
| Preferred Health Network | $307 | 296% |
| Healthstar | $307 | 296% |
| Beech Street | $314 | 303% |
| Security Health Plan | $314 | 303% |
| Swedish American | $314 | 303% |
| Private Health Care System | $314 | 303% |
| Employer's Coalition on Health | $314 | 303% |
| Benchmark Health | $314 | 303% |
| Wellmark/Healthnetwork | $321 | 309% |
| Multiplan | $332 | 320% |
| National Provider Network | $332 | 320% |
| Integrated Health Plan | $332 | 320% |
| Health Smart | $332 | 320% |
| Wea Insurance Group | $332 | 320% |
| Unicare | $3,678 - $8,500 | 3544% |