Psychotherapy session (60 minutes)
Facility: Kansas City Orthopaedic Institute
Billing Code: 90837 (CPT)
- CPT Billing Code: 90837
- Insurance Median: $368
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.03x 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 203% of the Medicare baseline (a markup of 103%). 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 |
|---|---|---|
| Aetna | $142 | 78% |
| UnitedHealthcare | $142 | 78% |
| Cigna | $151 | 83% |
| Blue Cross Blue Shield | $368 | 203% |
Consumer Guidance & Cost Commentary
For this psychotherapy session at the Kansas City Orthopaedic Institute in Leawood, KS, the negotiated rates range from $142 to $368 depending on your specific insurance carrier. While Aetna, UnitedHealthcare, and Cigna have a single plan each paying $142, $142, and $151 respectively, Blue Cross Blue Shield has five plans paying a higher negotiated rate of $368. It is important to note that these negotiated amounts are often higher than the cash price; for patients with high-deductible plans, paying out-of-pocket for the cash rate can sometimes be cheaper than the insurance negotiated rate if the deductible has not yet been met. Additionally, many hospitals offer prompt-pay discounts of 20% to 50% for upfront payment, which can significantly reduce the final cost, so it is advisable to ask the billing department about self-pay or prompt-pay rates before scheduling your appointment.
The Medicare benchmark for this service is $181.34, which serves as a baseline for evaluating the facility's pricing markup. The data indicates a comparison factor of 2.0 versus Medicare, suggesting the negotiated rates are double the Medicare amount. While the report does not provide specific cash or median paid values to compare against state or county averages, the facility is an Acute Care Hospital owned by a physician located in zip code 66211. If you receive a bill that exceeds these negotiated rates, you should request an itemized billing audit to identify any errors, double-billing, or unbundled codes, as over 80% of hospital bills contain discrepancies. Always verify your deductible status before using insurance to ensure you