CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Phillips County Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90834
  • Insurance Median: $139
  • Cash Discount Price: $208
  • vs. Medicare Baseline: 0.77x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Phillips County Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $208. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.77x the Medicare baseline. Located in 1150 State Street, Phillipsburg, KS.
Cash / Self-Pay
$208

Average discount available for prompt cash payment at this facility.

Insurance Median
$139

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)
Cash / Self-Pay: $208 (115%)
Insurance Median: $139 (77%)
Cash: $208 (115% of Medicare)
Ins. Median: $139 (77% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $100 - $284 55%
UnitedHealthcare $111 - $350 61%
Health Partners-All Plans $139 - $350 77%
Medicaid / KanCare $139 - $350 77%

Consumer Guidance & Cost Commentary

For a psychotherapy session lasting 45 minutes at Phillips County Hospital in Phillipsburg, Kansas, the cash price is $208.00, which is lower than the facility's negotiated rates with major payers like Blue Cross Blue Shield, UnitedHealthcare, and Health Partners-All Plans. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance contracts often result in higher allowed amounts than cash prices due to administrative overhead and contract dynamics. If you have a high-deductible plan, paying the cash price of $208.00 upfront may save you money compared to your insurance's negotiated rate, provided you have not yet met your deductible. It is always advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower your out-of-pocket costs.

When reviewing your final bill, ensure you receive a detailed itemized statement rather than a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If you encounter a balance bill for an out-of-network service at this in-network facility, remember that the No Surprises Act generally protects you from being billed the difference between the provider's full charge and your insurance's allowed amount for emergency care and non-emergency services at in-network hospitals. To resolve any discrepancies, request a formal written audit dispute sent via certified mail to the billing supervisor, avoiding verbal settlements that may not be documented. By comparing your specific charges against the Medicare benchmark of $181.34 for this procedure, you can verify if the facility's pricing aligns with fair market value standards

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1150 State Street, Phillipsburg, KS 67661
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals