CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Elkhart General Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $447
  • Cash Discount Price: $432
  • vs. Medicare Baseline: 2.46x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Elkhart General Hospital is $447. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $432. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.46x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.
Cash / Self-Pay
$432

Average discount available for prompt cash payment at this facility.

Insurance Median
$447

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: $432 (238%)
Insurance Median: $447 (246%)
Cash: $432 (238% of Medicare)
Ins. Median: $447 (246% 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 246% of the Medicare baseline (a markup of 146%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Mclaren (Mi $90 50%
UnitedHealthcare $90 - $447 50%
Devoted Healthcare $133 - $177 73%
Blue Cross Blue Shield $139 - $502 77%
Aetna $168 - $450 93%
Humana $168 - $466 93%
Pace $168 93%
Plain Church $252 - $532 139%
Caresource $269 - $864 148%
Mhs $303 - $864 167%
Cha $399 - $519 220%
Immergrun $399 - $532 220%
Php $432 - $466 238%
Cigna $479 - $505 264%
Multiplan $479 264%
Signature $485 267%
Encore $492 271%
Heartland $665 367%
Mdwise $864 476%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 E Blvd, Elkhart, IN 46514
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals