CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: St Luke Hospital & Living Center

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90834
  • Insurance Median: $268
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at St Luke Hospital & Living Center is $268. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.48x the Medicare baseline. Located in 535 South Freeborn, Marion, KS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$268

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%)
Insurance Median: $268 (148%)
Ins. Median: $268 (148% 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
Humana $268 148%
UnitedHealthcare $268 148%
Kansas Department Of Health And Environment $268 148%
Blue Cross Blue Shield $268 148%
Va Ccn $268 148%
Bluestem Pace $268 148%
Ambetter / Centene $270 149%

Consumer Guidance & Cost Commentary

For this psychotherapy session at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate is $268, which aligns perfectly with the lowest and highest amounts paid by all seven insurance plans listed, including Humana, UnitedHealthcare, and Blue Cross Blue Shield. This consistency indicates that the facility has a uniform contract with these payers, resulting in a predictable out-of-pocket cost for members who have met their deductibles. While the facility is a Critical Access Hospital with government ownership, the data does not provide specific cash or self-pay rates; however, patients with high-deductible plans should verify if paying cash directly could be more affordable than the insurance negotiated rate, as commercial contracts often include administrative overhead that can make the billed amount higher than the actual cost of care.

It is important to note that the facility's negotiated rate of $268 is significantly higher than the Medicare benchmark of $181.34, reflecting a markup common in commercial healthcare pricing. Under federal protections like the No Surprises Act, patients should not be balance billed for out-of-network services at this in-network facility, and any surprise bills should be disputed in writing rather than paid immediately. Additionally, since the facility offers prompt-pay discounts to patients who settle accounts upfront, it is advisable to contact the billing department before scheduling to request a self-pay classification and potential fee reduction, ensuring you receive the most accurate and transparent pricing available for your specific situation.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 535 South Freeborn, Marion, KS 66861
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals