CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: St Joseph's Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $182
Cash Discount Price: $154
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at St Joseph's Hospital is $182. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $154. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.00x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.

Cash / Self-Pay

$154

Average discount available for prompt cash payment at this facility.

Insurance Median

$182

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: $154 (85%)

Insurance Median: $182 (100%)

Cash: $154 (85% of Medicare)

Ins. Median: $182 (100% 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
Clear Spring Health of Illinois	$43	24%
Molina Healthcare	$43 - $214	24%
Sae Hospice	$43	24%
Aetna	$43 - $150	24%
Humana	$43	24%
Blue Cross Blue Shield	$43	24%
UnitedHealthcare	$43 - $214	24%
Amish Community	$60	33%
Naphcare	$90	50%
Celtic Insurance Company	$94	52%
Claim Doc	$107	59%
Hopetrust	$107	59%
Wellfirst	$137	76%
Cigna	$143	79%
First Health	$158	87%
Healthlink	$182	100%
Multiplan/Phcs	$182	100%
Healthcare Finest Network (Hfn)	$193	106%
Provider Network of America	$193	106%
Qtc Medical Group of Illinois	$214	118%
Healthscope	$214	118%
Current Health Solutions	$214	118%
Consociate Group	$214	118%
Illinois Breast and Cervical Cancer Program	$214	118%
Mental Health Network	$214	118%
Health Alliance Medical Plans	$214	118%
Interplan	$214	118%
Meridian Health Plan	$327	180%

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 $154.
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 St Joseph's Hospital 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.