Psychotherapy session (60 minutes)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 90837 (CPT)
- CPT Billing Code: 90837
- Insurance Median: $525
- Cash Discount Price: $655
- vs. Medicare Baseline: 2.90x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 290% of the Medicare baseline (a markup of 190%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $207 | 114% |
| Humana | $377 | 208% |
| Tricare | $407 | 224% |
| Aetna | $477 - $693 | 263% |
| UnitedHealthcare | $477 - $770 | 263% |
| Medicaid / KanCare | $477 - $770 | 263% |
| Ambetter / Centene | $525 | 290% |
| Health Partners - All Plans | $732 | 404% |
| Healthy Blue Mcaid - All Plans | $770 | 425% |
Consumer Guidance & Cost Commentary
For a psychotherapy session lasting 60 minutes at Trego County Lemke Memorial Hospital, the cash median price is $655.00, while the median negotiated rate across insurance plans is $477.00. This facility is a Critical Access Hospital in Wakeeney, KS, and its pricing structure reflects the specific dynamics of local healthcare delivery. It is important to note that while commercial insurance contracts often cap charges at negotiated rates, these amounts can sometimes exceed the cash price for patients with high-deductible plans. In such cases, paying cash directly may result in a lower out-of-pocket cost compared to using an in-network insurer, provided the patient's deductible has been met.
When evaluating the value of this service, it is essential to compare rates against the federal Medicare benchmark rather than the hospital's full chargemaster list. The Medicare amount for this procedure is $181.34, which serves as the objective baseline for fair pricing. Commercial negotiated rates typically range from 200% to 300% of the Medicare rate, whereas fair pricing is generally defined as 120% to 150% of this benchmark. Patients should verify their specific plan details before scheduling, as some in-network providers may charge significantly more than others. Additionally, asking the hospital about "self-pay" or "prompt-pay" discounts before check-in can help secure immediate cash-flow incentives that bypass costly administrative billing cycles.