Psychotherapy session (60 minutes)
Facility: Mcpherson Hospital
Billing Code: 90837 (CPT)
- CPT Billing Code: 90837
- Insurance Median: $363
- Cash Discount Price: $352
- vs. Medicare Baseline: 2.00x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 200% of the Medicare baseline (a markup of 100%). 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.
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% |
| UnitedHealthcare | $163 - $475 | 90% |
| Humana | $163 | 90% |
| Blue Cross Blue Shield | $163 | 90% |
| Va Ccn - All Plans | $163 | 90% |
| Wellcare Mcr Adv - All Plans | $163 | 90% |
| Ambetter / Centene | $188 | 104% |
| Wppa - All Plans | $332 | 183% |
| Central Plains - All Plans | $356 | 196% |
| Medical Associates - All Plans | $356 | 196% |
| Christian Health Aid - All Plans | $380 | 210% |
| Aetna | $392 - $475 | 216% |
| Multiplan - All Plans | $428 | 236% |
| Health Partners - All Plans | $451 | 249% |
| First Health - All Plans | $451 | 249% |
| Cigna | $451 | 249% |
| Medicaid / KanCare | $475 | 262% |
| Health Blue Mcaid - All Other Plans | $484 | 267% |
Consumer Guidance & Cost Commentary
For this psychotherapy session at McPherson Hospital in McPherson, Kansas, the cash price is $352, while the median amount paid by insurance is $386. This cash rate is lower than the facility's negotiated rates for most payers, such as Tricare and Healthy Blue Mcr Adv, which both pay exactly $144 and $163 respectively, but higher than the lowest negotiated rates found among other insurers like UnitedHealthcare and Humana, which range from $163 to $475. Patients with high-deductible plans may find paying the cash price of $352 more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. However, patients should always ask the hospital directly about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can further reduce the final bill.
It is important to understand that commercial insurance rates are often higher than cash prices due to administrative costs and contract structures, even though they provide coverage. The facility's Medicare benchmark is $181.34, which serves as a baseline for evaluating pricing; commercial negotiated rates typically range from 200% to 300% of this amount, while fair pricing is generally considered to be between 120% and 150%. If a patient receives an itemized bill that includes unexpected charges or appears to be a summary rather than a detailed statement, they should request a full line-by-line audit to identify errors, unbundled codes, or services not rendered. Since over 80% of hospital bills contain errors, obtaining a detailed CPT-coded statement is the most effective way to ensure accuracy and avoid