CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: St Luke Hospital & Living Center

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $281
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at St Luke Hospital & Living Center is $281. 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 1.55x 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
$281

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: $281 (155%)
Ins. Median: $281 (155% 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
Va Ccn $280 154%
Blue Cross Blue Shield $280 154%
Humana $280 154%
UnitedHealthcare $280 154%
Kansas Department Of Health And Environment $280 154%
Bluestem Pace $280 154%
Ambetter / Centene $283 156%

Consumer Guidance & Cost Commentary

For this psychotherapy session at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rates are consistently $280 to $283 across seven major payers, including Blue Cross Blue Shield and Humana. This aligns closely with the state average of $281.00, indicating that the facility is charging a standard market rate for this service. While the gross charge listed is $550.00, insurance contracts cap the billed amount at the negotiated rate, protecting members from the full chargemaster price. However, patients should be aware that these negotiated rates often exceed cash prices due to administrative overheads; if you have a high-deductible plan or no insurance, paying the cash price directly might result in lower out-of-pocket costs, though the facility currently lists no specific cash or median paid amounts for this code.

The facility's billing structure is anchored by a Medicare benchmark of $181.34, which serves as the objective baseline for evaluating pricing markups. The negotiated rates of approximately $280 represent a significant markup over this federal standard, a common dynamic in commercial healthcare where administrative costs and network tiering influence final prices. To minimize costs, patients should proactively contact the hospital's billing department to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payments. Additionally, if you are concerned about potential balance billing or errors, request a full itemized bill before scheduling, as summary invoices often obscure individual charges and may contain unbundled codes or services not rendered.

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