CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Community Hospital of Staunton

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $271
Cash Discount Price: $168
vs. Medicare Baseline: 1.49x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Community Hospital of Staunton is $271. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.49x the Medicare baseline. Located in 400 N Caldwell St, Staunton, IL.

Cash / Self-Pay

$168

Average discount available for prompt cash payment at this facility.

Insurance Median

$271

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: $168 (93%)

Insurance Median: $271 (149%)

Cash: $168 (93% of Medicare)

Ins. Median: $271 (149% 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
Tricare	$97 - $150	53%
Medicare (plans)	$99 - $162	55%
Clear Spring Health Ma	$102 - $167	56%
Self Pay	$168	93%
Cigna	$216	119%
Blue Cross Blue Shield	$251 - $335	138%
Healthlink	$251 - $285	138%
Health Alliance Commercial	$268 - $335	148%
Aetna	$271 - $335	149%
Multiplan/Phcs	$285	157%
Beech Street	$305	168%
Medicaid / KanCare	$320 - $335	176%
UnitedHealthcare	$335	185%

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 $168.
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 Community Hospital of Staunton 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.