CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Knoxville Hospital & Clinics

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $98
Cash Discount Price: $116
vs. Medicare Baseline: 0.54x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Knoxville Hospital & Clinics is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.54x the Medicare baseline. Located in 1002 South Lincoln Street, Knoxville, IA.

Cash / Self-Pay

$116

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $116 (64%)

Insurance Median: $98 (54%)

Cash: $116 (64% of Medicare)

Ins. Median: $98 (54% 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
Molina Mcaid/Chip - All Plans	$27 - $329	15%
Aetna	$28	15%
Amerigroup Mcaid	$28 - $337	15%
Amerigroup Mcr - All Other Plans	$28 - $136	15%
Humana	$28 - $273	15%
Iowa Total Care Mcaid - All Plans	$28 - $321	15%
UnitedHealthcare	$28 - $154	15%
Oscar-All Plans	$42 - $134	23%
Health Partners New Bus	$45 - $148	25%
Medical Associates Health Plan-All Other Plans	$48 - $141	26%
Cigna	$62 - $148	34%
Health Partners-All Other Plans	$62 - $148	34%
Medica Op And Profee Only-All Plans	$62	34%
Midlands Choice-All Plans	$62 - $148	34%
Wellmark Hmo 7/1/22	$147 - $220	81%
Wellmark Ppo 7/1/22-All Other Plans	$153 - $243	84%

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 $116.
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 Knoxville Hospital & Clinics 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.