CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Kirby Medical Center

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $164
Cash Discount Price: $318
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Kirby Medical Center is $164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $318. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.90x the Medicare baseline. Located in 1000 Medical Center Drive, Monticello, IL.

Cash / Self-Pay

$318

Average discount available for prompt cash payment at this facility.

Insurance Median

$164

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: $318 (175%)

Insurance Median: $164 (90%)

Cash: $318 (175% of Medicare)

Ins. Median: $164 (90% 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
UnitedHealthcare	$70 - $365	39%
Blue Cross Blue Shield	$73 - $519	40%
Aetna	$92 - $371	51%
Meridian	$92 - $164	51%
Wellcare	$92 - $164	51%
Molina	$94 - $169	52%
Zelis (Hfn)	$115 - $477	63%
Humana	$122 - $398	67%
Catepillar, Inc.	$124 - $450	68%
Cigna	$424	234%
Healthlink	$477	263%
Multiplan/Phcs	$504	278%

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 $318.
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 Kirby Medical Center 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.