CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Pulaski Memorial Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $246
Cash Discount Price: $263
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Pulaski Memorial Hospital is $246. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $263. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.36x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$263

Average discount available for prompt cash payment at this facility.

Insurance Median

$246

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: $263 (145%)

Insurance Median: $246 (136%)

Cash: $263 (145% of Medicare)

Ins. Median: $246 (136% 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
Ambetter / Centene	$117	65%
Blue Cross Blue Shield	$117 - $376	65%
Caresource Mcaid Hip	$117	65%
Caresource Mcare Hmo	$117	65%
Cenpatico Mcaid Hip	$117	65%
Mdwise Mcaid Hip - All Other Plans	$117	65%
Mhs Mcaid Hip	$117	65%
UnitedHealthcare	$117 - $376	65%
Humana	$118 - $303	65%
Mhs Mcare Allwell	$118	65%
Aetna	$136	75%
Caresource Exch Hmo Hix - All Other Plans	$146	81%
Sagamore Rose Acre	$280	154%
Sagamore - All Other Plans	$285	157%
Encore Ppo - All Other Plans	$320	176%
Community Health Alliance - All Plans	$335	185%
Encore Workers Comp	$339	187%
Multiplan - All Plans	$339	187%
Cigna	$358	197%
Caresource Mcaid Hhw	$376	207%
Cenpatico Mcaid Hhw - All Other Plans	$376	207%
Mdwise Mcaid Hcc	$376	207%
Mdwise Mcaid Hhw	$376	207%
Mhs Mcaid Hhw/Hcc	$376	207%

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 $263.
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 Pulaski Memorial 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.