CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Palos Community Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $341
Cash Discount Price: $372
vs. Medicare Baseline: 1.88x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Palos Community Hospital is $341. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $372. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.88x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$372

Average discount available for prompt cash payment at this facility.

Insurance Median

$341

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: $372 (205%)

Insurance Median: $341 (188%)

Cash: $372 (205% of Medicare)

Ins. Median: $341 (188% 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
Blue Cross Blue Shield	$85 - $531	47%
Cigna	$99 - $531	55%
Aetna	$114 - $531	63%
UnitedHealthcare	$241 - $531	133%
Carelon Behavioral Health [159]	$266	147%
Healthlink [125]	$266 - $531	147%
First Health Plan [6034]	$302 - $398	167%
Magellan Behavioral Hlth [136]	$319	176%
The Alliance [1703]	$341	188%
Multiplan/Phcs [142]	$372 - $531	205%
Compsych [112]	$398	219%
Beechstreet [176]	$425	234%
Health'S Finest Network [126]	$451	249%
Galaxy Health Network [220]	$531	293%
Global Excel [1712]	$531	293%
Health Alliance [181]	$531	293%

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 $372.
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 Palos Community 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.