Psychotherapy session (60 minutes)
Facility: Ellsworth County Medical Center
Billing Code: 90837 (CPT)
- CPT Billing Code: 90837
- Insurance Median: $181
- Cash Discount Price: $201
- vs. Medicare Baseline: 1.00x 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.
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 |
|---|---|---|
| Va Ccn-All Plans | $94 | 52% |
| Triwest -All Plans | $94 | 52% |
| Healthy Blue Mcr Adv | $94 | 52% |
| Humana | $94 - $191 | 52% |
| UnitedHealthcare | $131 - $201 | 72% |
| Blue Cross Blue Shield | $142 - $150 | 78% |
| First Health - All Plans | $181 | 100% |
| Aetna | $181 | 100% |
| Cigna | $191 | 105% |
| Healthy Blue Mcaid- All Other Plans | $201 | 111% |
| Coventry Mcaid-All Plans | $201 | 111% |
| Medicaid / KanCare | $201 | 111% |
| Providers Care-Wppa-All Plans | $302 | 167% |
Consumer Guidance & Cost Commentary
For this psychotherapy session at Ellsworth County Medical Center, the cash price is $201, which matches the facility's gross charge and the highest negotiated rates from several payers. While the median negotiated amount across all plans is $181, patients with high-deductible plans might find paying the full cash price of $201 more affordable than their insurance allowing a higher allowed amount, as commercial rates often exceed cash prices due to administrative overhead. It is important to note that this facility is a Critical Access Hospital in Ellsworth, Kansas, and while specific county or state average data was not provided in the report, patients should always verify their specific plan's deductible status before scheduling to ensure they understand their out-of-pocket responsibility.
To minimize unexpected costs, consumers should proactively request a prompt-pay discount or self-pay rate before check-in, as these upfront payments can bypass costly insurance billing cycles and administrative fees. If a balance bill arises from an out-of-network service, patients should not pay immediately out of fear; instead, they should dispute the bill with their insurer and request a No Surprises Act audit to ensure compliance with federal protections. Additionally, if a summary bill is received, patients should demand a full itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through a formal written dispute sent to the billing supervisor.