CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: St Anthony Regional Hospital & Nursing Home

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $91
Cash Discount Price: $98
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at St Anthony Regional Hospital & Nursing Home is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.50x the Medicare baseline. Located in 311 South Clark Street, Carroll, IA.

Cash / Self-Pay

$98

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $98 (54%)

Insurance Median: $91 (50%)

Cash: $98 (54% of Medicare)

Ins. Median: $91 (50% 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
Aetna	$33 - $101	18%
Humana	$33 - $162	18%
Medica Mcr - All Plans	$33 - $91	18%
UnitedHealthcare	$33 - $146	18%
Va Ccn - All Plans	$33 - $91	18%
Wellpoint Mcr Adv	$33 - $91	18%
Ia Total Care Mcr	$34 - $94	19%
Ia Total Care Mcaid	$38 - $190	21%
Molina Mcaid - All Plans	$38 - $194	21%
Wellpoint Mcaid - All Other Plans	$38 - $190	21%
Ia Total Care Comm - All Other Plans	$43 - $118	24%
Midlands Choice - All Plans	$86 - $102	47%
Wellmark Hmo	$132 - $208	73%
Wellmark Ppo-All Other Plans	$132 - $228	73%

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 $98.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90834.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Anthony Regional Hospital & Nursing Home is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90834.
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.