Psychotherapy session (45 minutes)
Facility: Hiawatha Community Hospital
Billing Code: 90834 (CPT)
- CPT Billing Code: 90834
- Insurance Median: $327
- Cash Discount Price: $420
- vs. Medicare Baseline: 1.80x 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 |
|---|---|---|
| Blue Cross Blue Shield | $95 - $100 | 52% |
| UnitedHealthcare | $155 - $361 | 85% |
| Aetna | $155 - $339 | 85% |
| Humana | $157 | 87% |
| Ambetter / Centene | $186 | 103% |
| Centrus Health Direct - All Plans | $315 | 174% |
| Oscar - All Plans | $315 | 174% |
| Preferred Hlth - All Plans | $378 | 208% |
| Wppa Providrs Care - All Plans | $399 | 220% |
| Cigna | $399 | 220% |
| Multiplan - All Plans | $407 | 224% |
| Midlands Choice - All Plans | $407 | 224% |
| Healthy Blue Mcaid - All Plans | $420 | 232% |
Consumer Guidance & Cost Commentary
For this psychotherapy session at Hiawatha Community Hospital, the cash price is $420.00, which matches the facility's gross charge and the median paid by cash-paying patients. This rate is significantly higher than the state average, as indicated by a 1.8x markup compared to Medicare's benchmark of $181.34. While commercial insurance plans like Blue Cross Blue Shield and UnitedHealthcare negotiate rates ranging from $95 to $361, these negotiated amounts often exceed the cash price. Patients with high-deductible plans may find paying the $420.00 cash rate directly more cost-effective than relying on insurance, which could result in out-of-pocket costs exceeding the cash price if their deductible is not yet met.
To ensure you are receiving the most favorable rate, it is essential to request an itemized billing audit before finalizing payment, as summary bills can obscure individual charges or unbundled services. Additionally, you should inquire about prompt-pay discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing the administrative costs associated with insurance claims processing. Since this facility is a Critical Access Hospital in Kansas, verifying the specific self-pay or prompt-pay terms with the billing department prior to scheduling your visit is the most effective way to avoid unexpected costs and ensure transparency.