Psychotherapy session (45 minutes)
Facility: Wilson Medical Center
Billing Code: 90834 (CPT)
- CPT Billing Code: 90834
- Insurance Median: $120
- Cash Discount Price: $113
- 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 |
|---|---|---|
| Tricare | $80 | 44% |
| Aetna | $80 - $150 | 44% |
| Ambetter / Centene | $80 - $150 | 44% |
| UnitedHealthcare | $80 - $140 | 44% |
| Humana | $80 | 44% |
| Blue Cross Blue Shield | $99 - $150 | 55% |
| Cigna | $120 | 66% |
| Mulitplan-All Plans | $138 | 76% |
| Health Partners-All Plans | $138 | 76% |
Consumer Guidance & Cost Commentary
For this psychotherapy session at Wilson Medical Center in Neodesha, KS, the cash price is $113, which is lower than the facility's gross charge of $150 but higher than the median negotiated rate of $120 paid by most insurance plans. While commercial payers like Aetna and UnitedHealthcare typically negotiate rates between $80 and $150, the cash price of $113 may actually be the most affordable option for patients with high-deductible plans or those without insurance, as it avoids the administrative markup often found in negotiated rates. It is important to note that while the facility is a Critical Access Hospital with government ownership, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as paying upfront can sometimes bypass standard insurance billing cycles to secure immediate savings.
When evaluating costs, it is crucial to compare these rates against the Medicare benchmark rather than the hospital's full list price, as Medicare sets a scientifically validated baseline for the true cost of care. For this service, the Medicare amount is $181.34, meaning the cash price of $113 represents a significant reduction compared to the federal standard, whereas many commercial negotiated rates fall below this benchmark. If you receive a bill from an out-of-network provider at this facility, the No Surprises Act protects you from balance billing for non-emergency services, and you should never sign away your rights to dispute charges via consent waivers. To ensure accuracy, always request a detailed, itemized bill that breaks down every CPT code and charge, as summary invoices often hide errors or unbundled services that could be corrected through a formal audit.