CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Mercyone Elkader Medical Center

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $567
  • Cash Discount Price: $501
  • vs. Medicare Baseline: 3.13x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Mercyone Elkader Medical Center is $567. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $501. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 3.13x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$501

Average discount available for prompt cash payment at this facility.

Insurance Median
$567

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: $501 (276%)
Insurance Median: $567 (313%)
Cash: $501 (276% of Medicare)
Ins. Median: $567 (313% 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 313% of the Medicare baseline (a markup of 213%). 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.

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
Blue Cross Blue Shield $396 218%
Aetna $400 - $567 221%
Medicare (plans) $404 - $416 223%
UnitedHealthcare $424 - $674 234%
Iowa Total Care $479 264%
Medicaid / KanCare $486 - $488 268%
Amish Hospital Aid $533 294%
1199 National Benefit Fund $567 313%
Allied Benefit Systems $567 313%
Asr Health Benefits $567 313%
Christian Brother Services $567 313%
Coventry $567 313%
First Health $567 313%
Lucent Health $567 313%
Luminare Health $567 313%
Medical Mutual $567 313%
Meritain $567 313%
Trustmark Small Business Benefits $567 313%
Webtpa $567 313%
Centivo $601 331%
Health Choices $616 340%
Medical Associates $616 340%
Ambetter / Centene $673 371%
Geha $674 372%
Health Partners $741 409%
Auxiant $755 416%
Cigna $755 416%
Medica $755 416%
Midlands $755 416%
Midlands Choice $755 416%
Crime Victim Assistance $770 425%
Iowa Dept Of Public Health $770 425%
Claimdoc $805 444%
Nova $805 444%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 Davidson Street Nw, Elkader, IA 52043
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals