CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Stanford Health Care

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $364
Cash Discount Price: $365
vs. Medicare Baseline: 2.01x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Stanford Health Care is $364. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $365. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.01x the Medicare baseline. Located in 300 Pasteur Drive, Stanford, CA.

Cash / Self-Pay

$365

Average discount available for prompt cash payment at this facility.

Insurance Median

$364

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: $365 (201%)

Insurance Median: $364 (201%)

Cash: $365 (201% of Medicare)

Ins. Median: $364 (201% 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 201% of the Medicare baseline (a markup of 101%). 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 Plan Of San Mateo [31200]	$172	95%
Cigna	$233 - $274	128%
Healthnet	$261	144%
Beech St [10600]	$334	184%
Claritev [13400]	$334	184%
Kaiser Northern Ca [12900]	$334	184%
Private Healthcare Systems (Phcs) [14200]	$334	184%
Blue Card (Out Of State) [40000]	$364	201%
Blue Cross Blue Shield	$364 - $597	201%
Shca Comm Intel [20300000]	$364	201%
Healthnet Alt Payer [912100000]	$436	240%
Healthnet [12100]	$436	240%
Aetna	$527	291%
UnitedHealthcare	$538	297%
American Specialty Health Plan Alt Payer [971000000]	$597	329%
Blue Card (Out Of State) - Blue Shield [40200]	$597	329%
Blue Shield Alt Payer [970000000]	$597	329%
Blue Shield [70000]	$597	329%
Psych Blue Shield Alt Payer [970000100]	$597	329%

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 $365.
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 Stanford Health Care 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.