CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Adventist Health Tulare

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $145
Cash Discount Price: $65
vs. Medicare Baseline: 0.80x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Adventist Health Tulare is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.80x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.

Cash / Self-Pay

$65

Average discount available for prompt cash payment at this facility.

Insurance Median

$145

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: $65 (36%)

Insurance Median: $145 (80%)

Cash: $65 (36% of Medicare)

Ins. Median: $145 (80% 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.

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
Blue Cross Blue Shield	$38 - $223	21%
Ccipa Medi-Cal - All Plans	$38	21%
Healthnet Medi-Cal	$38	21%
Medi-Cal	$38	21%
Upn-United Physcn Ntwrk Mcal Profee Only	$38	21%
Blue Shield Mcare	$138	76%
Fhcn Pace Mcr Adv - All Plans	$138	76%
Medicare (plans)	$138	76%
Tricare	$138	76%
UnitedHealthcare	$138 - $161	76%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot	$138	76%
Aetna	$145	80%
Ah Employee Health Plan - All Plans	$152	84%
Cigna	$152	84%
Incentive Hlth - All Plans	$152	84%
Hs Interplan-All Plans	$172	95%
Cal Forensic Med Grp - All Plans	$179	99%
Healthnet Hmo/Ppo - All Other Plans	$201	111%
Blue Shield Epn	$224	124%
Blue Shield-All Other Plans	$237	131%

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 $65.
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 Adventist Health Tulare 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.