CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Kossuth Regional Health Center

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $287
Cash Discount Price: $486
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Kossuth Regional Health Center is $287. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $486. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.58x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.

Cash / Self-Pay

$486

Average discount available for prompt cash payment at this facility.

Insurance Median

$287

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: $486 (268%)

Insurance Median: $287 (158%)

Cash: $486 (268% of Medicare)

Ins. Median: $287 (158% 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
Humana	$134 - $307	74%
Va Ccn - All Plans	$134	74%
Amerigroup Mcr Adv - All Other Plans	$137 - $310	76%
UnitedHealthcare	$138 - $307	76%
Mercy One - All Plans	$141 - $304	78%
Sanford Pho Isno Mcr Adv Profee Only - All Plans	$141	78%
Midlands Choice - All Plans	$164 - $561	90%
Health Partners New Bus - All Other Plans	$178 - $561	98%
Blue Cross Blue Shield	$189 - $208	104%
Health Partners Exisiting Bus	$195 - $777	108%
Medical Associates - All Plans	$221 - $681	122%
Preferred Health - All Plans	$221 - $681	122%
Aetna	$244 - $777	135%
Multiplan - All Plans	$392 - $761	216%
Molina Mcaid/Chip - All Plans	$423 - $825	233%
Amerigroup Mcaid	$425 - $833	234%

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 $486.
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 Kossuth Regional Health 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.