CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Madison County Health Care System

Billing Code: 90837 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$250

about 1.4× the $181 Medicare rate · typically $155–$392

modeled estimate · not a bill or quote

What this hospital charges insurers

$218

Below the fair price — a good deal

about $32 under the fair price · 1.2× Medicare

Medicare pays $181 Fair price $250 This hospital $218 Cash price $360 Hospital's list price $450

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

Highest price of the 9 IA hospitals we have prices for — worth calling around.

Cheapest $122 Priciest $218

Black dot = this hospital, among the 9 IA hospitals with a price for this procedure. Full list below.

A fair price for a Psychotherapy session (60 minutes) is about $250 (about 1.4× the $181 Medicare rate). Madison County Health Care System charges insurers about $218, or about $360 in cash — below the fair price — a good deal. Located in Winterset, IA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$212	117%
Blue Cross Blue Shieldmajor	$208 - $228	115%
Aetnamajor	$194 - $292	107%
Amerigroup	$224	124%
Molina	$219	121%
Oscar Health	$290	160%
+ 14 smaller / regional plans	$194 - $450

Government programs also on file: Military & VA.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 360), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90837.

Insurance Before you use insurance

Call your insurance company to confirm Madison County Health Care System is in-network.
Ask your insurer whether prior approval is required for CPT code 90837.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Madison County Health Care System

Compare: Psychotherapy session (60 minutes) at other IA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.