Group therapy session
Facility: Mercy Hospital of Buffalo
Billing Code: 90853 (CPT)
- CPT Billing Code: 90853
- Insurance Median: $26
- Cash Discount Price: $51
- vs. Medicare Baseline: 0.25x 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 | $17 - $30 | 16% |
| Medicaid / KanCare | $18 - $27 | 17% |
| Univera Healthcare Essential [100170] | $20 - $22 | 19% |
| Univera Healthcare [100169] | $20 - $33 | 19% |
| VA Veterans Affairs [700001] | $21 - $27 | 20% |
| Amerigroup [350102] | $21 - $23 | 20% |
| Tuscarora Nation [550120] | $21 - $23 | 20% |
| Vna Option Mltc [350110] | $21 - $23 | 20% |
| Beacon Essential [350122] | $21 - $28 | 20% |
| Blue Cross Blue Shield | $21 - $35 | 20% |
| Independent Health Essential [100166] | $21 - $23 | 20% |
| Crime Victims [100176] | $21 - $23 | 20% |
| Excellus Rochester McD [350117] | $21 - $23 | 20% |
| Medicare (plans) | $23 - $28 | 22% |
| Covid19 Hrsa [45013] | $24 - $27 | 23% |
| Catholic Health Life Pace [400005] | $24 - $27 | 23% |
| Fallon Health [450115] | $24 - $27 | 23% |
| Champ VA [700002] | $24 - $27 | 23% |
| Hospice [550001] | $24 - $27 | 23% |
| Cigna | $24 - $39 | 23% |
| Fidelis Essential [100163] | $24 - $33 | 23% |
| Seneca Nation [450119] | $24 - $27 | 23% |
| Tricare | $24 - $27 | 23% |
| Aetna | $25 - $27 | 24% |
| Fidelis Dual Advantage [450120] | $25 - $28 | 24% |
| Humana | $25 - $27 | 24% |
| Wellcare Fidelis Dual [450451] | $25 - $28 | 24% |
| Wellcare [450129] | $26 - $30 | 25% |
| Ghi [100153] | $26 - $30 | 25% |
| Iha First Choice [800001] | $27 - $31 | 26% |
| Magnacare [100142] | $27 | 26% |
| Independent Health [100165] | $27 - $31 | 26% |
| Meritain [100063] | $27 | 26% |
| Fidelis Exchange [100164] | $28 - $33 | 27% |
| Beacon Health Options [100023] | $28 | 27% |
| Mvp Healthcare [100168] | $31 - $34 | 30% |
| UPMC Health Plan [100181] | $43 - $45 | 41% |
| Molina Essential [100167] | $48 - $52 | 46% |
| No Fault [114001] | $48 | 46% |
| Federal Workers Compensation [500100] | $48 | 46% |