CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Dukes Memorial Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $159
  • Cash Discount Price: $173
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Dukes Memorial Hospital is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $173. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.88x the Medicare baseline. Located in 275 W 12Th St, Peru, IN.
Cash / Self-Pay
$173

Average discount available for prompt cash payment at this facility.

Insurance Median
$159

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: $173 (95%)
Insurance Median: $159 (88%)
Cash: $173 (95% of Medicare)
Ins. Median: $159 (88% 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.

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
Department Of Veterans Affairs $37 - $147 20%
Tricare $37 - $147 20%
Aetna $40 - $377 22%
Blue Cross Blue Shield $40 - $772 22%
Humana $40 - $159 22%
Iu Health Plan $40 - $156 22%
Managed Health Services $40 - $317 22%
Medicare (plans) $40 - $156 22%
Node Devoted Health Mcr Adv $40 - $159 22%
Node Va $40 - $383 22%
UnitedHealthcare $40 - $162 22%
In Dept Of Correction $42 - $165 23%
Miami County Sheriffs Department $42 - $165 23%
Node Pphp Mcr Adv $42 - $167 23%
Lutheran Advanced Network $60 - $238 33%
Lutheran Three Rivers Preferred Plus 150 $60 - $238 33%
Node Lutheran Preferred Fixed 2 $60 - $238 33%
Align Network $64 - $254 35%
Lutheran Preferred $64 - $634 35%
Lutheran Three Rivers Preferred Plus 175 $70 - $278 39%
Encore Work Comp In $72 - $285 40%
Prime Health Services $72 - $595 40%
Partners Direct Health Llc $76 - $301 42%
Lutheran Northwest Health Preferred $80 - $317 44%
Three Rivers Preferred Plus $80 - $317 44%
Work Comp $80 - $317 44%
Physicians Health Plan $81 - $370 45%
Cigna $85 - $329 47%
Three Rivers Preferred $90 - $357 50%
Php Freedom $93 - $366 51%
Encore Kba Epo $96 - $381 53%
Amish Aid $100 - $396 55%
Encore Ppo $100 - $396 55%
Self Pay $100 - $436 55%
Sagamore Health Network $111 - $439 61%
Encore Kba Ppo $121 - $476 67%
Caresource $122 - $159 67%
Consumer Life $125 - $492 69%
One Call Wc $134 74%
Veterans Eval Services $150 83%
Medicaid / KanCare $159 88%
Mhs $159 88%
First Health $161 - $634 89%
Multiplan $163 - $642 90%
Encore Health Network $165 - $650 91%
Advantage Health Solutions $167 - $658 92%
Encore $181 - $714 100%
Us Department Of Labor $203 112%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 275 W 12Th St, Peru, IN 46970
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals