CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Memorial Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $480
Cash Discount Price: $426
vs. Medicare Baseline: 2.65x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Memorial Hospital is $480. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $426. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.65x the Medicare baseline. Located in 1454 N County Road 2050 E, Carthage, IL.

Cash / Self-Pay

$426

Average discount available for prompt cash payment at this facility.

Insurance Median

$480

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: $426 (235%)

Insurance Median: $480 (265%)

Cash: $426 (235% of Medicare)

Ins. Median: $480 (265% 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 265% of the Medicare baseline (a markup of 165%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$149 - $533	82%
Blue Cross Blue Shield	$149 - $533	82%
Cigna	$149 - $533	82%
Health Alliance	$149 - $533	82%
Humana	$149 - $533	82%
Meridian	$149 - $533	82%
Molina	$149 - $533	82%
UnitedHealthcare	$149 - $533	82%
Consociate	$453 - $533	250%
Healthlink	$453 - $533	250%
Private Healthcare Systems	$453	250%
Integrated Health Plan	$469	259%
First Health Network	$474 - $533	261%
Health Dynamics	$480	265%
Health Payors Org	$480	265%
Iowa Health Solutions	$480	265%
Multiplan	$480	265%
Preferred Plan Inc	$480	265%
Three Rivers Provider Network	$480	265%
Health First Network	$485	267%
Pponext	$485	267%
Corvel	$506	279%

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 $426.
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 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.