CMS Price Transparency Data

Group therapy session

Facility: Intermountain Health Sanpete Valley Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $105
Cash Discount Price: $83
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Intermountain Health Sanpete Valley Hospital is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 1.01x the Medicare baseline. Located in 1100 South Medical Drive, Mount Pleasant, UT.

Cash / Self-Pay

$83

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $83 (80%)

Insurance Median: $105 (101%)

Cash: $83 (80% of Medicare)

Ins. Median: $105 (101% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Health Plan of Nevada	$23 - $99	22%
Blue Cross Blue Shield	$23 - $105	22%
Aetna	$23 - $106	22%
Molina	$23 - $105	22%
Humana	$23 - $105	22%
Healthy U	$23 - $99	22%
UnitedHealthcare	$23 - $105	22%
Health Partners of Nevada	$23 - $33	22%
Selecthealth	$23 - $105	22%
American Health	$23 - $33	22%
Triwest	$35 - $100	34%
Injury Care of Nevada	$83	80%
Byu Risk Management	$94	91%
Corporation of the President	$94	91%
Corvel Corporation	$94	91%
Wcf Insurance	$94	91%
Tanner LLC	$105	101%
Pehp	$105	101%
Prodegi Corp Benefit	$105	101%
Utah Tech	$105	101%
Ifit	$105	101%
Cigna	$105	101%
Wise Network	$105	101%
Juniper Systems	$105	101%
Springtide	$105	101%
Emi Health	$105	101%
Deseret Mutual	$105	101%
Byu Athletics	$105	101%
Motivhealth	$105	101%
Lw Miller	$105	101%
Franklin County	$105	101%
Emi	$105	101%
Health Utah	$105	101%
Awh Connected	$105 - $106	101%
Global Excel	$105	101%
Medcare International	$105	101%
Campbell Scientific	$105	101%
Managed Care Admin	$105	101%
Uofu	$105	101%
Hygeia Corporation	$105	101%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $83.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90853.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Intermountain Health Sanpete Valley Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90853.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.