Psychotherapy session (45 minutes)
Facility: Clay County Medical Center
Billing Code: 90834 (CPT)
- CPT Billing Code: 90834
- Insurance Median: $181
- Cash Discount Price: $283
- vs. Medicare Baseline: 1.00x 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.
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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $177 - $349 | 98% |
| Aetna | $177 - $349 | 98% |
| Health Partners - All Plans | $181 - $356 | 100% |
| Multiplan- All Plans | $181 - $356 | 100% |
| UnitedHealthcare | $181 | 100% |
Consumer Guidance & Cost Commentary
For this psychotherapy session at Clay County Medical Center in Clay Center, KS, the cash price is $283.00, which matches the facility's median negotiated rate of $181.00 and the Medicare benchmark of $181.34. While the gross charge listed is $283.00, the actual amount paid by insurance for this service is typically $181.00, meaning patients with high-deductible plans might find paying the cash price directly more cost-effective if their insurance allowed amount exceeds the cash rate. It is important to note that this facility is a Critical Access Hospital with government-local ownership, and while the negotiated rate is lower than the gross charge, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to potentially reduce the final cost further.
The pricing data reflects standard billing mechanics where commercial rates are often higher than cash prices due to administrative overhead and contract structures. Although the facility's negotiated rate of $181.00 is consistent with the Medicare benchmark, patients should be aware that balance billing could occur if they receive care from out-of-network providers, even at an in-network hospital, though the No Surprises Act protects against surprise bills for emergency and non-emergency services at in-network facilities. To avoid unexpected costs, consumers should request an itemized bill to ensure no unbundled codes or services not rendered are included, and always dispute any summary bills that obscure individual line items before agreeing to payment terms.