CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Hamilton Memorial Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90834
  • Insurance Median: $304
  • Cash Discount Price: $337
  • vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Hamilton Memorial Hospital is $304. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $337. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.68x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.
Cash / Self-Pay
$337

Average discount available for prompt cash payment at this facility.

Insurance Median
$304

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: $337 (186%)
Insurance Median: $304 (168%)
Cash: $337 (186% of Medicare)
Ins. Median: $304 (168% 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.

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 $112 - $356 62%
Blue Cross Blue Shield $112 - $360 62%
Health Alliance $112 - $317 62%
Medicare (plans) $112 - $158 62%
UnitedHealthcare $112 - $284 62%
Wellcare $112 - $158 62%
Medicaid / KanCare $147 - $158 81%
Humana $158 87%
Alliance Coal $277 153%
Healthscope $277 153%
Wellfirst (Ssmhic) $277 153%
Hope Trust $297 164%
Cigna $311 172%
Hfn, Inc $317 - $356 175%
Healthlink $337 - $356 186%
Multiplan $337 186%
Siho $356 196%
Three Rivers Provider $356 196%
Healthsmart $376 207%
Stratose $376 207%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 S Marshall Avenue, McLeansboro, IL 62859
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals