CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Adventist Health Vallejo

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $660
Cash Discount Price: $194
vs. Medicare Baseline: 3.64x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Adventist Health Vallejo is $660. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $194. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 3.64x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.

Cash / Self-Pay

$194

Average discount available for prompt cash payment at this facility.

Insurance Median

$660

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: $194 (107%)

Insurance Median: $660 (364%)

Cash: $194 (107% of Medicare)

Ins. Median: $660 (364% 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 364% of the Medicare baseline (a markup of 264%). 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
Medi-Cal	$141	78%
Va Medi-Cal	$141	78%
Blue Shield Mcr Adv	$161	89%
Medicare (plans)	$161	89%
Napa County Mcal Child	$161	89%
Tricare	$161	89%
UnitedHealthcare	$161 - $823	89%
Va Mcr-All Other Plans	$161	89%
Ah Employee Health Plan-All Plans	$289	159%
Blue Shield Behav Hlth	$581	320%
Blue Shield Non-Epn-All Other Plans	$599	330%
Blue Shield Epn	$608	335%
Aetna	$671	370%
Phcs-All Plans	$710	392%
Western Growers-All Plans	$749	413%
Healthnet-All Plans	$792	437%
Interplan-All Plans	$839	463%
Choicecare-All Plans	$904	499%
Blue Cross Blue Shield	$951	524%
Beech Street-All Plans	$968	534%
Cigna	$1,033	570%
Kaiser-All Plans	$1,084	598%
Health Management Network-All Plans	$1,097	605%
Galaxy Network-All Plans	$1,162	641%
Three Rivers-All Plans	$1,162	641%

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 $194.
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 Vallejo 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.