CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Madison County Health Care System

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90834
  • Insurance Median: $276
  • Cash Discount Price: $340
  • vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Madison County Health Care System is $276. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $340. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.52x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$340

Average discount available for prompt cash payment at this facility.

Insurance Median
$276

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: $340 (187%)
Insurance Median: $276 (152%)
Cash: $340 (187% of Medicare)
Ins. Median: $276 (152% 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
Aetna $183 - $276 101%
Medical Associates Hp - All Plans $183 101%
Medigold-All Plans $183 101%
Tricare $183 101%
American Hp Mcr Adv-All Plans $192 106%
Iowa Total Care Mcaid-All Plans $200 110%
UnitedHealthcare $200 110%
Molina Mcaid/Chip -All Plans $207 114%
Blue Cross Blue Shield $208 - $228 115%
Amerigroup Mcaid-All Plans $212 117%
Madison County Sheriff-All Plans $212 117%
Oscar - All Plans $274 151%
Corvel Wc-All Plans $382 211%
Choicecare-All Plans $404 223%
First Choice-All Plans $404 223%
First Health-All Plans $404 223%
Integrated Hp-All Plans $404 223%
Mutual Of Omaha-All Plans $404 223%
Plaines Health-All Plans $404 223%
Preferred Hlth Ntwork-All Plans $404 223%
Principal Healthcare-All Plans $404 223%
Usa Managed Care-All Plans $404 223%
Medimore Employee Hp - All Plans $416 229%
Midlands Choice - All Plans $416 229%
Benefit Admin Of America-All Plans $425 234%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals