CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Grossmont Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $724
Cash Discount Price: $830
vs. Medicare Baseline: 3.99x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Grossmont Hospital is $724. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $830. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 3.99x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$830

Average discount available for prompt cash payment at this facility.

Insurance Median

$724

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: $830 (458%)

Insurance Median: $724 (399%)

Cash: $830 (458% of Medicare)

Ins. Median: $724 (399% 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 399% of the Medicare baseline (a markup of 299%). 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
Health Net	$70 - $774	39%
Aetna	$155 - $1,084	85%
Blue Cross Blue Shield	$166 - $995	92%
UnitedHealthcare	$180 - $1,084	99%
Blue Shield	$310 - $3,999	171%
Cigna	$310 - $774	171%
Humana	$328 - $376	181%
Kaiser	$328 - $531	181%
Interplan	$376	207%
Epic Americas	$434	239%
Medicare (plans)	$531 - $763	293%
Medi-Cal	$553 - $747	305%
Community Health Group	$608 - $907	335%
Molina	$608 - $1,084	335%
Indian Health Council	$616	340%
California Health And Wellness	$702	387%
Multiplan	$706	389%
Managed Health Network	$741 - $830	409%
San Diego Pace	$774 - $885	427%

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 $830.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90837.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Grossmont Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90837.
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.