CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Pulaski Memorial Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $358
Cash Discount Price: $383
vs. Medicare Baseline: 1.97x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Pulaski Memorial Hospital is $358. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $383. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.97x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$383

Average discount available for prompt cash payment at this facility.

Insurance Median

$358

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: $383 (211%)

Insurance Median: $358 (197%)

Cash: $383 (211% of Medicare)

Ins. Median: $358 (197% 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	$170	94%
Blue Cross Blue Shield	$170 - $547	94%
Caresource Mcaid Hip	$170	94%
Caresource Mcare Hmo	$170	94%
Cenpatico Mcaid Hip	$170	94%
Mdwise Mcaid Hip - All Other Plans	$170	94%
Mhs Mcaid Hip	$170	94%
UnitedHealthcare	$170 - $547	94%
Humana	$171 - $440	94%
Mhs Mcare Allwell	$171	94%
Aetna	$197	109%
Caresource Exch Hmo Hix - All Other Plans	$212	117%
Sagamore Rose Acre	$408	225%
Sagamore - All Other Plans	$414	228%
Encore Ppo - All Other Plans	$465	256%
Community Health Alliance - All Plans	$487	269%
Encore Workers Comp	$493	272%
Multiplan - All Plans	$493	272%
Cigna	$520	287%
Caresource Mcaid Hhw	$547	302%
Cenpatico Mcaid Hhw - All Other Plans	$547	302%
Mdwise Mcaid Hcc	$547	302%
Mdwise Mcaid Hhw	$547	302%
Mhs Mcaid Hhw/Hcc	$547	302%

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 $383.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90837.

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 90837.
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.