CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Northside Hospital Duluth

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $379
  • Cash Discount Price: $457
  • vs. Medicare Baseline: 2.09x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Northside Hospital Duluth is $379. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $457. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.09x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
$457

Average discount available for prompt cash payment at this facility.

Insurance Median
$379

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: $457 (252%)
Insurance Median: $379 (209%)
Cash: $457 (252% of Medicare)
Ins. Median: $379 (209% 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 209% of the Medicare baseline (a markup of 109%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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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 $77 - $286 42%
Institutional Gwinnett County Govt $77 - $109 42%
Medicaid / KanCare $77 - $126 42%
Caresource $79 - $227 44%
Amerigroup $92 - $138 51%
Cigna $92 - $384 51%
Champus Va $101 56%
Blue Cross Blue Shield $170 - $424 94%
Us Dept Of Labor Wc $172 95%
Clear Springs Eon Health $175 97%
Medicare (plans) $175 - $210 97%
UnitedHealthcare $175 97%
Va Ccn $175 97%
Aetna $177 - $414 98%
Humana $177 - $182 98%
Bccp $178 98%
Cbww $178 98%
Truths Community $178 98%
Coventry $179 - $414 99%
Kaiser $180 - $530 99%
Tricare $180 99%
Wellcare $180 99%
Clover Health $184 101%
Pruitt Health Premier $184 101%
Fairly Group $201 111%
Georgia Reproductive Specialists $244 135%
Medlien Healthcare Services $244 135%
Mti $257 142%
One Call Diagnostics $257 142%
Homelink $273 151%
Med Care Solutions $274 151%
Oscar $286 158%
Health One Alliance_Ppo $335 185%
Quick Trip $335 185%
Genex/Priority Care Solutions $337 186%
Spreemo $337 186%
Northside Health Network $378 208%
Authentic 4D $379 209%
Streamline Imaging $379 209%
Corvel Workers Comp $400 221%
Employers Choice Network $400 221%
Fieldale Farms Wc $421 232%
Georgia Workers Compensation $421 232%
Novanet_Ppo $426 235%
Phcs $457 252%
Beech Steet $518 286%
Multiplan $518 286%
Multiplan Workers Comp $518 286%
Careiq $609 336%
Dekalb_Department Of Health $609 336%
Fifa $609 336%
Institutional Marietta Surgery Center $609 336%
Institutional Veterans Evaluation Services $609 336%
Johnson Ferry Imaging $609 336%
Marietta Dermatology Clinical Research Inc $609 336%
Rabun County Boc $609 336%
West Paces Imaging Agreement $609 336%

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