Psychotherapy session (45 minutes)
Facility: Mcpherson Hospital
Billing Code: 90834 (CPT)
- CPT Billing Code: 90834
- Insurance Median: $344
- Cash Discount Price: $333
- vs. Medicare Baseline: 1.90x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $144 | 79% |
| Healthy Blue Mcr Adv | $163 | 90% |
| Humana | $163 | 90% |
| Wellcare Mcr Adv - All Plans | $163 | 90% |
| Blue Cross Blue Shield | $163 | 90% |
| UnitedHealthcare | $163 - $450 | 90% |
| Va Ccn - All Plans | $163 | 90% |
| Ambetter / Centene | $188 | 104% |
| Wppa - All Plans | $315 | 174% |
| Central Plains - All Plans | $338 | 186% |
| Medical Associates - All Plans | $338 | 186% |
| Christian Health Aid - All Plans | $360 | 199% |
| Aetna | $371 - $450 | 205% |
| Multiplan - All Plans | $405 | 223% |
| Cigna | $428 | 236% |
| Health Partners - All Plans | $428 | 236% |
| First Health - All Plans | $428 | 236% |
| Medicaid / KanCare | $450 | 248% |
| Health Blue Mcaid - All Other Plans | $459 | 253% |
Consumer Guidance & Cost Commentary
For this psychotherapy session at McPherson Hospital in McPherson, Kansas, the cash price is $333, which is lower than the facility's negotiated rates with most major payers. While the hospital's cash rate is below the gross charge of $450, patients should be aware that many insurance plans negotiate rates significantly higher than cash, such as UnitedHealthcare and Aetna, which have negotiated ranges extending up to $450. This dynamic suggests that for individuals with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly could result in lower total costs compared to having insurance process the claim, as the insurer's allowed amount often exceeds the cash rate.
The facility's pricing structure also highlights the importance of understanding balance billing and negotiated rate mechanics. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients must still verify their specific plan details, as some commercial payers like Healthy Blue Mcr Adv and Humana have negotiated a fixed rate of $163, which is higher than the cash price. Additionally, while the facility is a voluntary non-profit, the presence of a facility rating of 2 indicates areas for improvement in patient experience or quality metrics that consumers should consider alongside cost. To maximize savings, patients are encouraged to contact the hospital directly to inquire about self-pay discounts or prompt-pay incentives, which can further reduce the final bill before any insurance claim is submitted.