CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Alton Memorial Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $285
Cash Discount Price: $251
vs. Medicare Baseline: 1.57x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Alton Memorial Hospital is $285. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $251. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.57x the Medicare baseline. Located in One Memorial Drive, Alton, IL.

Cash / Self-Pay

$251

Average discount available for prompt cash payment at this facility.

Insurance Median

$285

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: $251 (138%)

Insurance Median: $285 (157%)

Cash: $251 (138% of Medicare)

Ins. Median: $285 (157% 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]	$188	104%
UnitedHealthcare	$188 - $311	104%
Healthlink [225]	$203 - $316	112%
Cigna	$220 - $334	121%
Consociate [478]	$226	125%
Sarah Bush Lincoln [636]	$226	125%
Cox Health Systems Insurance Company [220]	$230 - $272	127%
Health Alliance [224]	$230	127%
Humana	$232	128%
Apwu Health Plan [216]	$239	132%
Nalc Health Benefit Plan [242]	$239	132%
Priority Health [648]	$239	132%
Allied Benefits [498]	$242 - $311	133%
Hope Trust [806]	$242	133%
Mercy Behavioral Health [573]	$258	142%
Med-Pay [480]	$272 - $314	150%
Unicare [568]	$272 - $316	150%
Blue Cross Blue Shield	$273 - $364	151%
Aetna	$285 - $314	157%
Coresource [497]	$285	157%
Fmh Benefit Service Inc [222]	$285	157%
Mail Handlers [495]	$285	157%
Mh Net [273]	$299	165%
First Health Commercial [734]	$311	172%
Beechstreet [551]	$314	173%
Detego Health [868]	$314	173%
Health Systems Inc [620]	$314	173%
Healthcare Sol Mercy [609]	$314	173%
Multiplan Commercial [737]	$314	173%
Multiplan [240]	$314	173%
Phcs [244]	$314 - $334	173%
Preferred Health Professionals [561]	$316	174%
Hfn [563]	$334	184%
Medica [661]	$334	184%

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 $251.
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 Alton Memorial Hospital 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.