Psychotherapy session (45 minutes)
Facility: Ellsworth County Medical Center
Billing Code: 90834 (CPT)
- CPT Billing Code: 90834
- Insurance Median: $119
- Cash Discount Price: $132
- vs. Medicare Baseline: 0.66x 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 |
|---|---|---|
| Healthy Blue Mcr Adv | $62 | 34% |
| Triwest -All Plans | $62 | 34% |
| Va Ccn-All Plans | $62 | 34% |
| Humana | $62 - $125 | 34% |
| UnitedHealthcare | $86 - $132 | 47% |
| Blue Cross Blue Shield | $94 - $99 | 52% |
| Aetna | $119 | 66% |
| First Health - All Plans | $119 | 66% |
| Cigna | $125 | 69% |
| Coventry Mcaid-All Plans | $132 | 73% |
| Healthy Blue Mcaid- All Other Plans | $132 | 73% |
| Medicaid / KanCare | $132 | 73% |
| Providers Care-Wppa-All Plans | $198 | 109% |
Consumer Guidance & Cost Commentary
For this psychotherapy session at Ellsworth County Medical Center, the cash price is $132.00, which matches the facility's gross charge and the Medicare-approved amount of $181.34. While the facility is a Critical Access Hospital in Kansas, the data does not provide specific county or state average rates for comparison. However, patients should note that the median negotiated rate across all payers is $119.00, which is lower than the cash price. This suggests that for patients with high-deductible plans or those without insurance, paying the cash price of $132.00 might be more cost-effective than relying on insurance, as the insurer's allowed amount could exceed the cash rate. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, as paying upfront can sometimes bypass administrative fees and reduce the final bill.
The facility's pricing structure reflects standard commercial billing dynamics where negotiated rates vary significantly by insurer. For example, while Humana has a range of $62 to $125, UnitedHealthcare's range is $86 to $132, and Medicaid/KanCare is set at $132.00. It is important to understand that these negotiated rates are contractual ceilings designed to protect in-network members, but they do not guarantee the lowest possible price for every individual. If a patient receives care from an out-of-network provider or encounters services billed at the full chargemaster rate, they may face balance billing for the difference between the provider's full charge and the insurance allowed amount. To avoid unexpected costs, patients should request an itemized bill to review specific CPT codes and ensure no