CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: UW Health

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $151
Cash Discount Price: $34
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at UW Health is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.83x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $34 (19%)

Insurance Median: $151 (83%)

Cash: $34 (19% of Medicare)

Ins. Median: $151 (83% 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	$63 - $211	35%
Aetna	$92 - $221	51%
Humana	$92 - $181	51%
Medicare (plans)	$92 - $199	51%
Mychoice Wi Medical Adv	$92 - $181	51%
UnitedHealthcare	$92 - $235	51%
Quartz Fully Insured	$106 - $203	58%
Wps	$106	58%
Beloit Healt System	$122 - $276	67%
Medicaid / KanCare	$124	68%
Cigna	$133 - $244	73%
Mercy Care	$148	82%
Workers Comp	$148	82%
Ecoh	$155 - $241	85%
Hfn	$155 - $241	85%
Alliance Premier Network	$167 - $201	92%
Quartz Aso	$167 - $211	92%
The Alliance	$201 - $215	111%
Wps Ppo	$237	131%
Mercycare	$286	158%
First Health/Coventry	$301	166%
Health Payment Systems	$357	197%
Healthsmart	$357	197%
Sheboygan Employers Health Network	$381	210%
Multiplan	$426	235%

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 $34.
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 UW Health 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.