CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Phillips County Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $213
  • Cash Discount Price: $250
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Phillips County Hospital is $213. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $250. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.17x the Medicare baseline. Located in 1150 State Street, Phillipsburg, KS.
Cash / Self-Pay
$250

Average discount available for prompt cash payment at this facility.

Insurance Median
$213

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: $250 (138%)
Insurance Median: $213 (117%)
Cash: $250 (138% of Medicare)
Ins. Median: $213 (117% 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 $151 - $304 83%
UnitedHealthcare $170 - $375 94%
Medicaid / KanCare $213 - $375 117%
Health Partners-All Plans $213 - $375 117%

Consumer Guidance & Cost Commentary

For this psychotherapy session at Phillips County Hospital, the facility's cash price of $250 is lower than the average negotiated rates paid by major insurers like UnitedHealthcare and Health Partners-All Plans, which range between $213 and $375. While the cash rate is higher than the facility's median negotiated rate of $213, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allows a higher amount than the cash price. It is important to note that the facility is a Critical Access Hospital in Phillipsburg, Kansas, and while the data does not provide a direct comparison to state or county averages for this specific code, the cash price remains a key benchmark for self-pay patients.

Patients should be aware that commercial insurance contracts often include administrative overhead that inflates the baseline price, meaning the negotiated rates can sometimes exceed the cash price despite being "in-network." To secure the best possible rate, individuals should ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront. Additionally, if you receive a bill from an out-of-network provider at this in-network facility, you may be protected by the No Surprises Act, which bans balance billing for emergency and non-emergency services; in such cases, you should dispute any unexpected charges with your insurer rather than paying immediately.

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