CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Tri-City Medical Center

Billing Code: 90834 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$202

about 1.1× the $181 Medicare rate · typically $105–$267

modeled estimate · not a bill or quote

What this hospital charges insurers

$256

Above the fair price

about $54 over the fair price · 1.4× Medicare

Medicare pays $181 Fair price $202 This hospital $256 Cash price $229 Hospital's list price $382

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $67 Priciest $256

Black dot = this hospital, among the 9 CA hospitals with a price for this procedure. Full list below.

A fair price for a Psychotherapy session (45 minutes) is about $202 (about 1.1× the $181 Medicare rate). Tri-City Medical Center charges insurers about $256, or about $229 in cash — above the fair price. Located in Oceanside, CA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $202. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Kaiser Permanente Humana

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$161 - $176	89%
Blue Cross Blue Shieldmajor	$212 - $227	117%
Aetnamajor	$76 - $627	42%
Cignamajor	$283 - $301	156%
Kaiser Permanentemajor	$134	74%
Health Net	$91 - $300	50%
Molina	$115	63%
Providence Health Plan	$115	63%
+ 3 smaller / regional plans	$95 - $312

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 229), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90834.

Insurance Before you use insurance

Call your insurance company to confirm Tri-City Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 90834.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Tri-City Medical Center

Compare: Psychotherapy session (45 minutes) at other CA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.