CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Alton Memorial Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $254
Cash Discount Price: $226
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Alton Memorial Hospital is $254. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $226. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.40x the Medicare baseline. Located in One Memorial Drive, Alton, IL.

Cash / Self-Pay

$226

Average discount available for prompt cash payment at this facility.

Insurance Median

$254

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: $226 (125%)

Insurance Median: $254 (140%)

Cash: $226 (125% of Medicare)

Ins. Median: $254 (140% 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
Healthscope Benefits [258]	$170	94%
UnitedHealthcare	$170 - $280	94%
Blue Cross Blue Shield	$172 - $328	95%
Healthlink [225]	$183 - $285	101%
Cigna	$198 - $302	109%
Consociate [478]	$204	112%
Sarah Bush Lincoln [636]	$204	112%
Cox Health Systems Insurance Company [220]	$207 - $245	114%
Health Alliance [224]	$207	114%
Humana	$210	116%
Aetna	$214 - $285	118%
Allied Benefits [498]	$214 - $285	118%
Coresource [497]	$214 - $285	118%
Fmh Benefit Service Inc [222]	$214 - $285	118%
Mail Handlers [495]	$214 - $285	118%
Apwu Health Plan [216]	$215	119%
Nalc Health Benefit Plan [242]	$215	119%
Priority Health [648]	$215	119%
Hope Trust [806]	$219	121%
Med-Pay [480]	$245 - $283	135%
Unicare [568]	$245 - $285	135%
Mercy Behavioral Health [573]	$258	142%
First Health Commercial [734]	$280	154%
Beechstreet [551]	$283	156%
Detego Health [868]	$283	156%
Health Systems Inc [620]	$283	156%
Healthcare Sol Mercy [609]	$283	156%
Multiplan Commercial [737]	$283	156%
Multiplan [240]	$283	156%
Phcs [244]	$283 - $302	156%
Preferred Health Professionals [561]	$285	157%
Mh Net [273]	$299	165%
Hfn [563]	$302	167%
Medica [661]	$302	167%

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 $226.
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 Alton Memorial Hospital 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.