CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Adventist Health St Helena

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $534
Cash Discount Price: $146
vs. Medicare Baseline: 2.94x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Adventist Health St Helena is $534. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.94x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$534

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)

Cash / Self-Pay: $146 (81%)

Insurance Median: $534 (294%)

Cash: $146 (81% of Medicare)

Ins. Median: $534 (294% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $181.34 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 294% of the Medicare baseline (a markup of 194%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Va Medi-Cal	$96	53%
Blue Shield Bh Mcr Adv	$236	130%
Blue Shield Mcr Adv	$236	130%
Kaiser Mcr Adv	$236	130%
Tricare	$236	130%
UnitedHealthcare	$236 - $619	130%
Va Mcr - All Other Plans	$236	130%
Ah Employee Health Plan - All Plans	$424	234%
Blue Shield Behav Hlth	$437	241%
Blue Shield Non-Epn	$451	249%
Blue Shield Epn-All Other Plans	$457	252%
Aetna	$505	278%
Phcs-All Plans	$534	294%
Western Growers-All Plans	$563	310%
Healthnet-All Plans	$595	328%
Interplan-All Plans	$631	348%
Blue Cross Blue Shield	$644 - $715	355%
Choicecare-All Plans	$680	375%
Beech Street-All Plans	$728	401%
Cigna	$777	428%
Kaiser-All Other Plans	$796	439%
Health Management Network-All Plans	$825	455%
Galaxy Network-All Plans	$874	482%
Three Rivers-All Plans	$874	482%

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 $146.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90834.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health St Helena is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90834.
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.