CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Memorial Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90834
  • Insurance Median: $394
  • Cash Discount Price: $350
  • vs. Medicare Baseline: 2.17x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Memorial Hospital is $394. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $350. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.17x the Medicare baseline. Located in 1454 N County Road 2050 E, Carthage, IL.
Cash / Self-Pay
$350

Average discount available for prompt cash payment at this facility.

Insurance Median
$394

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: $350 (193%)
Insurance Median: $394 (217%)
Cash: $350 (193% of Medicare)
Ins. Median: $394 (217% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 217% of the Medicare baseline (a markup of 117%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $123 - $438 68%
Blue Cross Blue Shield $123 - $438 68%
Cigna $123 - $438 68%
Health Alliance $123 - $438 68%
Humana $123 - $438 68%
Meridian $123 - $438 68%
Molina $123 - $438 68%
UnitedHealthcare $123 - $438 68%
Consociate $372 - $438 205%
Healthlink $372 - $438 205%
Private Healthcare Systems $372 205%
Integrated Health Plan $385 212%
First Health Network $390 - $438 215%
Health Dynamics $394 217%
Health Payors Org $394 217%
Iowa Health Solutions $394 217%
Multiplan $394 217%
Preferred Plan Inc $394 217%
Three Rivers Provider Network $394 217%
Health First Network $399 220%
Pponext $399 220%
Corvel $416 229%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1454 N County Road 2050 E, Carthage, IL 62321
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals