Psychotherapy session (60 minutes)
Facility: Kiowa District Hospital
Billing Code: 90837 (CPT)
- CPT Billing Code: 90837
- Insurance Median: $238
- Cash Discount Price: $200
- vs. Medicare Baseline: 1.31x 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 |
|---|---|---|
| Tricare | $98 | 54% |
| Blue Cross Blue Shield | $150 | 83% |
| Health Partners Of Ks-All Plans | $220 | 121% |
| Humana | $226 | 125% |
| Healthchoice-All Plans | $230 | 127% |
| Multiplan-All Plans | $235 | 130% |
| Gbs Insurance - All Plans | $235 | 130% |
| Medicare (plans) | $238 | 131% |
| UnitedHealthcare | $238 - $250 | 131% |
| Aetna | $238 | 131% |
| Triwest-All Plans | $238 | 131% |
| Medicaid / KanCare | $250 | 138% |
| Providers Care (Wppa)-All Plans | $375 | 207% |
| Liberty Healthshare-All Plans | $404 | 223% |
Consumer Guidance & Cost Commentary
For CPT code 90837, representing a 60-minute psychotherapy session at Kiowa District Hospital in Kiowa, KS, the facility's cash price is $200.00, which is lower than the median negotiated rate of $236.00 paid by insurers. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates from payers like UnitedHealthcare and Providers Care (Wppa) can exceed the cash amount. To secure the lowest possible cost, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions typically range from 20% to 50% and bypass the administrative overhead associated with insurance claims processing.
The data indicates that the facility's cash rate of $200.00 is below the state and county averages for this service, offering a potential savings opportunity for those without insurance coverage. However, commercial payers negotiate rates that often exceed the cash price due to administrative costs and contract dynamics; for instance, UnitedHealthcare's range spans $238.00 to $250.00, while Providers Care (Wppa) charges the full $375.00. Because the No Surprises Act protects patients from balance billing for emergency care and non-emergency services at in-network facilities, patients should verify their network status and avoid signing out-of-network consent waivers unless absolutely necessary. If a patient receives a bill exceeding the cash price, they should request a formal itemized audit to identify any unbund