CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: North Shore Medical Center

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90834
  • Insurance Median: $158
  • Cash Discount Price: $304
  • vs. Medicare Baseline: 0.87x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at North Shore Medical Center is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $304. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.87x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$304

Average discount available for prompt cash payment at this facility.

Insurance Median
$158

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: $304 (168%)
Insurance Median: $158 (87%)
Cash: $304 (168% of Medicare)
Ins. Median: $158 (87% 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.

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
Oscar Health Plan Hix $19 10%
Imagine Health $30 17%
Bc/Bs Of Fl Network Blue $44 24%
Bc/Bs Myblue Hmo Hix $46 25%
Bc/Bs Of Fl Blue Select Exchange Non Par $46 25%
Bc/Bs Of Fl Health Options Hmo $46 25%
Bc/Bs Of Fl Simplyblue $49 27%
Bc/Bs Of Fl Ppo $52 29%
Cigna $53 - $163 29%
Avmed Broad Network $64 35%
Humana $94 - $152 52%
Medicaid / KanCare $94 - $304 52%
UnitedHealthcare $95 - $156 52%
Veterans Administration Mill Bill $109 60%
Healthsun Health Plans $111 - $163 61%
Self Pay/Uninsured $132 - $194 73%
Employer Direct Healthcare $134 - $158 74%
Medicare (plans) $140 - $340 77%
Leon Health Inc $155 85%
Aetna $156 - $304 86%
Devoted Health $156 86%
Tricare $156 86%
Bc/Bs Of Fl Phs $158 87%
Hospice Other $158 87%
Veterans Administration Vaccn $158 87%
Longevity Health Plan $166 92%
Magellan Behavioral Health $182 100%
Florida Pace Centers $187 103%
Bright Health Management Commercial $190 105%
Centurion Prison $194 107%
Dimensions International $198 109%
First Health $207 114%
Dimension Health Ppo $228 126%
Dimension Health Wc $228 126%
Workers Compensation $228 126%
Avmed Exchange $277 153%
Ambetter / Centene $292 161%
Molina Marketplace Program Exchange $301 166%
Beacon Health Strategies Commercial $304 168%
Commercial Non-Contracted $304 168%
Self Pay - Mcd Pending 100 Percent $304 168%
Single Case Agreement $304 168%
United Behavioral Health Psych $304 168%
Auto Insurance $316 174%
Avmed Select Network $323 178%
Amerihealth Caritas Next Exchange $340 187%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals