CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Ashland Health Center

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $212
  • Cash Discount Price: $170
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Ashland Health Center is $212. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.17x the Medicare baseline. Located in 625 South Kentucky Street, Ashland, KS.
Cash / Self-Pay
$170

Average discount available for prompt cash payment at this facility.

Insurance Median
$212

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: $170 (94%)
Insurance Median: $212 (117%)
Cash: $170 (94% of Medicare)
Ins. Median: $212 (117% 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
Blue Cross Blue Shield $71 39%
Compalliance-All Plans $170 94%
Health Partners Of Kansas-All Plans $180 99%
Multiplan-All Plans $208 115%
Aetna $212 117%
Health Choice-All Plans $212 117%
Medicare (plans) $212 117%
Healthy Blue Mcr Adv - All Other Plans $212 117%
UnitedHealthcare $212 117%
Medica Mcare - All Plans $212 117%
Medicaid / KanCare $212 117%
Providers Care (Wppa)-All Plans $318 175%

Consumer Guidance & Cost Commentary

For a psychotherapy session lasting 60 minutes at Ashland Health Center in Ashland, KS, the facility's gross charge is $212.00. While the median negotiated rate across 12 payers is also $212.00, patients with high-deductible plans may find the cash price of $170.00 more advantageous, as it is lower than the insurer's allowed amount. It is important to note that Medicare sets a benchmark of $181.34 for this service, which serves as a cost baseline; commercial rates often exceed this figure due to administrative overhead and contract dynamics. Although the data does not provide specific county or state average comparisons for this procedure, the cash rate remains a significant factor for those seeking to minimize out-of-pocket costs before meeting their insurance deductible.

Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like labs or emergency physicians are out-of-network. To avoid these surprises, consumers should request a full itemized bill before paying, ensuring no unbundled codes or services not rendered are included. Additionally, if you choose to pay directly, ask the facility about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if settled upfront. If you receive a summary bill, insist on a detailed line-by-line statement to identify any errors, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 625 South Kentucky Street, Ashland, KS 67831
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals