CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Saint Joseph Regional Medical Center

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90834
  • Insurance Median: $109
  • Cash Discount Price: $227
  • vs. Medicare Baseline: 0.60x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Saint Joseph Regional Medical Center is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $227. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.60x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$227

Average discount available for prompt cash payment at this facility.

Insurance Median
$109

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: $227 (125%)
Insurance Median: $109 (60%)
Cash: $227 (125% of Medicare)
Ins. Median: $109 (60% 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

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $69 - $227 38%
Saint Pius X $75 41%
Aetna $102 - $112 56%
Albany County Correctional Facility $102 56%
Ambetter / Centene $102 56%
Amish Mennonite $102 56%
Ascension St. Vincent Public Safety Medical $102 56%
Bcccp-Michigan $102 56%
Bccp $102 56%
Blue Cross Blue Shield $102 - $109 56%
Bmc Healthnet $102 56%
Breast Grant-Connecticut $102 56%
Broward County Dept Of Health $102 56%
California Health And Wellness $102 56%
Cardinal Innovations Lme $102 56%
Care Connections Of Northern Iowa $102 56%
Care Oregon Ohp $102 56%
Cencal Health Plan $102 56%
Cenpatico $102 56%
Champva $102 56%
Chhuny $102 56%
Childrens Comm Health Plan $102 56%
Childrens Medical Services Title 19 $102 56%
Christian Brother Services $102 56%
Cigna $102 - $227 56%
City Of Philadelphia $102 56%
Cmh Allegan County $102 56%
Cmh Ausable Valley $102 56%
Cmh Barry County $102 56%
Cmh Bay-Arenac County $102 56%
Cmh Berrien County $102 56%
Cmh Cass County $102 56%
Cmh Central Mi County $102 56%
Cmh Clinton-Eaton-Ingham County $102 56%
Cmh Detroit Wayne Integrated Health Network $102 56%
Cmh Genesee County $102 56%
Cmh Ionia County $102 56%
Cmh Jackson County/Lifeways $102 56%
Cmh Kalamazoo $102 56%
Cmh Kent County $102 56%
Cmh Lenawee County $102 56%
Cmh Livingston County $102 56%
Cmh Macomb $102 56%
Cmh Misc $102 56%
Cmh Monroe County $102 56%
Cmh Montcalm County $102 56%
Cmh Muskegon County $102 56%
Cmh Newaygo County $102 56%
Cmh North Country $102 56%
Cmh Northern Lakes County $102 56%
Cmh Oakland County $102 56%
Cmh Ottawa County $102 56%
Cmh Van Buren County $102 56%
Cmh Washtenaw County $102 56%
Cmh Wayne County/Carelink $102 56%
Cmh Wayne Cty/Com Liv Svcs $102 56%
Cmh West Mi County $102 56%
Community Benefit Health $102 56%
Community Care Behavorial Health $102 56%
Community Care Partners $102 56%
Community Health Choice $102 56%
Connections Csp $102 56%
County Coroner $102 56%
County Funding Generic $102 56%
Covid19 Hrsa Uninsured Testing And Treatment Fund $102 56%
Dean Wi Badgercare $102 56%
Delaware County Department Of Health $102 56%
Delaware First Health $102 56%
Delta Dental Nj $102 56%
Dph Tb Program $102 56%
Dscc $102 56%
Eastpointe Lme $102 56%
Family Health Network $102 56%
Freedom First Healthcare $102 56%
Fresno County Ccs $102 56%
Ghc Scw Wi Badgercare $102 56%
Harbor Health $102 56%
Health Safety Net $102 56%
Healthy Blue Ne $102 56%
Hennepin Health $102 56%
Humana $102 - $109 56%
Id County Ada $102 56%
Id County Canyon $102 56%
Id County Cat Fund $102 56%
Id County Other $102 56%
Id County Payette $102 56%
Idaho Dept Health And Wellfare $102 56%
Idaho Womens Health Check $102 56%
Indiana Breast Cervical Cancer $102 56%
Inland Empire Health Plan $102 56%
Intercommunity Health Ohp $102 56%
Iowa Total Care $102 56%
Jai Medical System $102 56%
Kern Family Health Plan $102 56%
Keystone First $102 56%
Keystone First Chip $102 56%
La Care Health Plan $102 56%
Lakeland Care Inc $102 56%
Managed Health Services - Indiana $102 56%
Maryland Breast & Cervical Program $102 56%
Maryland Healthy Smiles - Scion Dental $102 56%
Maryland Physicians Care $102 56%
Massachusetts Behavioral Health Partnership $102 56%
Mdwise $102 56%
Medi-Cal $102 56%
Medi-Cal Healthnet $102 56%
Medstar Dc Healthy Family $102 56%
Medstar Md Health Choice $102 56%
Meritain $102 56%
Mo Home State Health Plan $102 56%
Molina Centennial Care $102 56%
Nascentia Health Options $102 56%
Nebraska Total Care $102 56%
New York Cancer Services Program $102 56%
Nextlevel Health $102 56%
Oregon Screenwise $102 56%
Pace Of Southwest Michigan $102 - $109 56%
Paramount Advantage $102 56%
Parkland Community Health Plan $102 56%
Partners Behavioral Lme $102 56%
Peach State Healthplan $102 56%
Philadelphia County Funding $102 56%
Preferred One $102 56%
Presbyterian Centennial Care $102 56%
Prestige Health Choice $102 56%
Priority Partners $102 56%
Robert F Sing Program $102 56%
Rx 340B Pass Along $102 56%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $102 56%
Rx Medi-Cal $102 56%
Rx Meridian Rx $102 56%
Ryan White Florida Mssrp $102 56%
Sandhills Center Lme $102 56%
Screening For Life $102 56%
St Joseph County Hlth Dpt $102 56%
Stephenson Cty Health $102 56%
Sunshine State Health Plan $102 56%
Superior Health $102 56%
Tenncare $102 56%
Texas Children'S Health Plan $102 56%
Tricare $102 56%
Trillium Community Ohp $102 56%
Triwest Health Alliance $102 56%
Tufts Health Public Plans $102 56%
UnitedHealthcare $102 - $156 56%
Us Family Health Plan $102 56%
Vaya Health Lme $102 56%
Veterans Eval Services $102 56%
Washtenaw Health Plan $102 56%
Wellsense Health Plan $102 56%
Wi Womens Wellness $102 56%
Bcn Domestic $108 60%
Blue Benefit Administrators Of Massachusetts $108 60%
Blue Care Network $108 60%
Blue Distinction Transplant $108 60%
Blue Shield - Ca $108 60%
Blue Shield - Id (Regence) $108 60%
Blue Shield - Ny Highmark Northeastern $108 60%
Blue Shield - Ny Highmark Western $108 60%
Blue Shield - Pa (Highmark) $108 60%
Blue Shield - Wa (Regence) $108 60%
Health Choices $108 60%
Kaiser Domestic $108 60%
Pre-Employment $108 60%
Wc Domestic $108 60%
Align Senior Care $109 60%
Ally Align Care Adv $109 60%
American Health Advantage Of Idaho $109 60%
American Health Plan $109 60%
Aurora Special Needs $109 60%
Blue Care Network Advantage $109 60%
Blue Shield - De (Highmark) Medciare Advantage $109 60%
Care Dimensions $109 60%
Care Improvement Plus $109 60%
Care Resources Pace $109 60%
Careplus Health Plans $109 60%
Cca - Zing Health $109 60%
Cca Senior Care Options $109 60%
Central Valley Medical Services Corp Pace $109 60%
Champion Health Plan Mcr Advantage $109 60%
Clear Spring Health $109 60%
Clover Health $109 60%
Commonwealth Care Alliance $109 60%
Community Pace At Home $109 60%
Eddy Senior Care-Pace $109 60%
Eddy Seniorcare Pace $109 60%
Elementcare $109 60%
Evercare $109 60%
Everence $109 60%
Gateway Health Plan $109 60%
Genesys Pace Of Genesee County $109 60%
Georgia Health Advantage $109 60%
Gold Advantage $109 60%
Gpa Croell Redi Mix $109 60%
Health America Advantra $109 60%
Highmark Health Options Dual Plan $109 60%
Hope Select Pace $109 60%
Horizon Nj Total Care $109 60%
Hudson Headwaters Pace $109 60%
Huron Valley Pace $109 60%
Innovative Integrated Health Community Plans $109 60%
Iowa Health Advantage $109 60%
Johns Hopkins Advantage Md $109 60%
Lasso Healthcare Msa $109 60%
Life St Marys Pace $109 60%
Lifecircles Pace $109 60%
Longevity Health Plan $109 60%
Longevity Ipa Of Michigan Llc Health Plan Isnp $109 60%
Martins Point Generations Advantage $109 60%
Mass General Brigham Mcr Adv $109 60%
Medicare (plans) $109 - $114 60%
Medipak Advantage $109 60%
Mercy Life $109 60%
Mercyone Cedar Valley $109 60%
Meridian Complete $109 60%
Michigan Complete Health $109 60%
Nascentia Health Plus $109 60%
New Centry Health Careplus $109 60%
Osu Prime Care Advantage $109 60%
Pace Cny $109 60%
Pace Iowa Immanuel Pathways $109 60%
Pace Southeast $109 60%
Pace-Trinity Health $109 60%
Peak Pace Solutions $109 60%
Perennial Advantage $109 60%
Preferred Care Partners $109 60%
Presbyterian Senior Plan $109 60%
Provider Partners Health Plan Of Illinois $109 60%
Pruitthealth Premier $109 60%
Reliance Community Care Partners Care Resources Pace $109 60%
Rx Allwin $109 60%
Rx Grane Grnmedd $109 60%
Rx Retiree Rx Care $109 60%
Scan Health Plan Mcr Ipa Meritage Oon $109 60%
Secure Horizons Ma Pffs $109 60%
Serenity Pace $109 60%
Siouxland Pace $109 60%
Solis Health Plans $109 60%
Sunnyview-Pace Finance Dept $109 60%
Texan Plus $109 60%
The Health Plan $109 60%
Thome Pace $109 60%
Todays Options $109 60%
Tribute Health Plans $109 60%
Um Health Advantage $109 60%
Union Health Service $109 60%
Welbe Health $109 60%
Wellmed $109 60%
Andrie Inc $112 62%
East Greenbush Central School District $112 62%
Genex Wc $112 62%
Healthsmart Workers Comp $112 62%
Jag Source $112 62%
New York State Insurance Fund $112 62%
Njm Insurance Group $112 62%
Rx Heatlhcomp $112 62%
Rx Restat $112 62%
Rx Saif Opdp Wc $112 62%
Rx Worker'S Comp $112 62%
Veterans Administration $112 62%
Wc Accident Fund $112 62%
Wc Ace $112 62%
Wc Acs Federal Employees $112 62%
Wc Acuity $112 62%
Wc Advantage $112 62%
Wc Aegis $112 62%
Wc Aig $112 62%
Wc Aims $112 62%
Wc Alaska National Ins $112 62%
Wc Align Network $112 62%
Wc Allied $112 62%
Wc Am Trust N America $112 62%
Wc American Claims Mgmt $112 62%
Wc Amerisure $112 62%
Wc Amtrust $112 62%
Wc Asu Risk Mgt $112 62%
Wc Benetech $112 62%
Wc Berkley Admin $112 62%
Wc Broadspire $112 62%
Wc Broward County $112 62%
Wc Bunch & Associates $112 62%
Wc California State Comp Ins $112 62%
Wc California State Ins Fund $112 62%
Wc Capitol Area Health Consortium $112 62%
Wc Ccmsi $112 62%
Wc Chartis $112 62%
Wc Chubb $112 62%
Wc Cirma $112 62%
Wc City Of Albany $112 62%
Wc City Of Sioux City $112 62%
Wc Claims Mgmt Inc $112 62%
Wc Cna $112 62%
Wc Comp One Admin C/O Manageability $112 62%
Wc Compone Admin $112 62%
Wc Corvel $112 62%
Wc Ct Healthcare Trust $112 62%
Wc Donegal Insurance Group $112 62%
Wc Emc Insurance Company $112 62%
Wc Employee Mutual $112 62%
Wc Enablecomp $112 62%
Wc Erie $112 62%
Wc Esis $112 62%
Wc Evolutions $112 62%
Wc Fcci $112 62%
Wc Fed Ex $112 62%
Wc Federal Black Lung $112 62%
Wc Federated $112 62%
Wc Finley Occupational Health $112 62%
Wc First Agency/Occunet $112 62%
Wc Ford Motor $112 62%
Wc Fresno Unified Emp $112 62%
Wc Gallagher Bassett $112 62%
Wc General Motors $112 62%
Wc Generic $112 62%
Wc Genex Care For Ohio $112 62%
Wc Great West Casualty $112 62%
Wc Guarantee Insurance $112 62%
Wc Guard Insurance Company $112 62%
Wc Hab $112 62%
Wc Hartford $112 62%
Wc Hastings $112 62%
Wc Health Management $112 62%
Wc Heritage Summit $112 62%
Wc Hireright $112 62%
Wc Horizon $112 62%
Wc Icw Group $112 62%
Wc Idaho State Ins Fund $112 62%
Wc Intercare Insurance $112 62%
Wc Intermountain $112 62%
Wc Johns Eastern $112 62%
Wc Kemberton $112 62%
Wc Key Ins & Benefit Solutions $112 62%
Wc Liberty Mutual $112 62%
Wc Mac Risk Management $112 62%
Wc Massachusetts $112 62%
Wc Mdia $112 62%
Wc Meadowbrook Claim $112 62%
Wc Medical Administrators $112 62%
Wc Meijers $112 62%
Wc Memic $112 62%
Wc Mercy Workcare $112 62%
Wc Michigan $112 62%
Wc Michigan Millers Mutual $112 62%
Wc Mitchell Frankenmuth $112 62%
Wc Mra $112 62%
Wc Nationwide $112 62%
Wc Nca Comp $112 62%
Wc New York $112 62%
Wc New York Special Funds $112 62%
Wc North American Rishces $112 62%
Wc Northeast Health $112 62%
Wc Notre Dame $112 62%
Wc Novanet $112 62%
Wc O'Hara Corp $112 62%
Wc Occ Health Allen $112 62%
Wc Ohio Bureau $112 62%
Wc One Call Medical $112 62%
Wc Paradigm $112 62%
Wc Peerless $112 62%
Wc Pma $112 62%
Wc Praxis Health Network $112 62%
Wc Price Chopper $112 62%
Wc Procura Management $112 62%
Wc Qualcare $112 62%
Wc Quiktrip $112 62%
Wc Reny Company $112 62%
Wc Rev Claims $112 62%
Wc Risico $112 62%
Wc Rural Mutual $112 62%
Wc Saif Oregon $112 62%
Wc Secura $112 62%
Wc Sedgwick $112 62%
Wc Sentry $112 62%
Wc Sheakley Unicomp $112 62%
Wc Smile Lodge $112 62%
Wc Society $112 62%
Wc Srs $112 62%
Wc Taconic (Mro) $112 62%
Wc Taconic Farms $112 62%
Wc Travelers $112 62%
Wc Triad Group $112 62%
Wc Tristar $112 62%
Wc Troy Ny $112 62%
Wc Tyson $112 62%
Wc Unified Health Services $112 62%
Wc United Heartland $112 62%
Wc Us Dept Of Labor $112 62%
Wc Velocity $112 62%
Wc Walmart $112 62%
Wc West Bend $112 62%
Wc West Bend Mutual/Argent $112 62%
Wc Winnebago Industries $112 62%
Wc Yankee Trails $112 62%
Wc York Risk $112 62%
Wc Zenith $112 62%
Wc Zurich $112 62%
Provider Partners Health Plan Of Indiana $123 68%
Ameriben $136 75%
Caresource $145 80%
Geha $156 86%
Community Health Alliance $157 87%
Phcs $204 112%
Allied Benefit Systems $226 125%
Auxiant $226 - $227 125%
Benefit Administrative Systems,Llc $226 125%
Custom Design Benefits $226 125%
Encore Health $226 - $227 125%
Key Benefit Administrator $226 125%
Luminare Health (Detroit) $226 125%
Physicians Health Plan Northern Indiana Health Insurance $226 125%
Plain Church Group $227 125%
Sagamore Health Network $227 125%
Signature Care $227 125%
Wc Encore Health Network $227 125%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals