CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Northside Hospital Duluth

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90834
  • Insurance Median: $288
  • Cash Discount Price: $343
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Northside Hospital Duluth is $288. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $343. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.59x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
$343

Average discount available for prompt cash payment at this facility.

Insurance Median
$288

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: $343 (189%)
Insurance Median: $288 (159%)
Cash: $343 (189% of Medicare)
Ins. Median: $288 (159% 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
Ambetter / Centene $58 - $215 32%
Institutional Gwinnett County Govt $58 - $82 32%
Medicaid / KanCare $58 - $94 32%
Caresource $59 - $180 33%
Champus Va $68 37%
Amerigroup $69 - $119 38%
Cigna $69 - $288 38%
Us Dept Of Labor Wc $115 63%
Blue Cross Blue Shield $128 - $319 71%
Mti $174 96%
One Call Diagnostics $174 96%
Clear Springs Eon Health $175 97%
Medicare (plans) $175 - $210 97%
UnitedHealthcare $175 97%
Va Ccn $175 97%
Aetna $177 - $311 98%
Humana $177 - $182 98%
Bccp $178 98%
Cbww $178 98%
Truths Community $178 98%
Coventry $179 - $311 99%
Kaiser $180 - $398 99%
Tricare $180 99%
Wellcare $180 99%
Georgia Reproductive Specialists $183 101%
Medlien Healthcare Services $183 101%
Clover Health $184 101%
Homelink $184 101%
Pruitt Health Premier $184 101%
Fairly Group $201 111%
Med Care Solutions $206 114%
Oscar $215 119%
Health One Alliance_Ppo $251 138%
Quick Trip $251 138%
Northside Health Network $283 156%
Novanet_Ppo $320 176%
Genex/Priority Care Solutions $337 186%
Spreemo $337 186%
Phcs $343 189%
Authentic 4D $379 209%
Streamline Imaging $379 209%
Beech Steet $388 214%
Multiplan $388 214%
Multiplan Workers Comp $388 214%
Corvel Workers Comp $400 221%
Employers Choice Network $400 221%
Fieldale Farms Wc $421 232%
Georgia Workers Compensation $421 232%
Careiq $457 252%
Dekalb_Department Of Health $457 252%
Fifa $457 252%
Institutional Marietta Surgery Center $457 252%
Institutional Veterans Evaluation Services $457 252%
Johnson Ferry Imaging $457 252%
Marietta Dermatology Clinical Research Inc $457 252%
Rabun County Boc $457 252%
West Paces Imaging Agreement $457 252%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals