CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: St Lukes Regional Medical Center

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $196
Cash Discount Price: $456
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at St Lukes Regional Medical Center is $196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $456. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.08x the Medicare baseline. Located in 2720 Stone Park Boulevard, Sioux City, IA.

Cash / Self-Pay

$456

Average discount available for prompt cash payment at this facility.

Insurance Median

$196

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: $456 (251%)

Insurance Median: $196 (108%)

Cash: $456 (251% of Medicare)

Ins. Median: $196 (108% 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
Nebraska Total Care	$102 - $148	56%
Aetna	$132 - $393	73%
Blue Cross Blue Shield	$135 - $196	74%
Molina	$135 - $160	74%
Amerivantage	$138 - $164	76%
Humana	$138 - $164	76%
UnitedHealthcare	$138 - $429	76%
Amerigroup	$142	78%
Iowa Total Care	$142	78%
Health Partners Open Network	$193 - $240	106%
Wellmark Uph Self-Funded	$196	108%
Avera Health Plan	$198 - $371	109%
Medica Exchange Inspire	$294	162%
Medica Exchange Insure	$330	182%
Cigna	$333 - $359	184%

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 $456.
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 St Lukes Regional Medical Center 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.