Psychotherapy session (60 minutes)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 90837 (CPT)
- CPT Billing Code: 90837
- Insurance Median: $270
- Cash Discount Price: $186
- vs. Medicare Baseline: 1.49x 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 | $142 - $150 | 78% |
| UnitedHealthcare | $175 - $350 | 97% |
| Providers Care (Wppa)-All Plans | $306 - $612 | 169% |
Consumer Guidance & Cost Commentary
For this psychotherapy session at Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash median rate of $186.00 is notably lower than the negotiated rates paid by major payers like UnitedHealthcare ($175–$350) and Providers Care ($306–$612). While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rates exceed this amount, as paying out-of-pocket can sometimes result in lower total costs. It is important to note that the cash rate of $186.00 is significantly higher than the Medicare benchmark of $181.34, which serves as the objective baseline for evaluating hospital pricing markups under federal standards.
Commercial insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40%, resulting in negotiated rates that can average 200% to 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of Medicare. Before scheduling, patients should verify their specific plan's allowed amount and check for "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid in full upfront. Additionally, because over 80% of hospital bills contain errors, consumers should request a detailed, itemized statement to review specific CPT codes and ensure no services were unbundled or incorrectly charged before finalizing payment.