Psychotherapy session (60 minutes)
Facility: Clay County Medical Center
Billing Code: 90837 (CPT)
- CPT Billing Code: 90837
- Insurance Median: $265
- Cash Discount Price: $340
- vs. Medicare Baseline: 1.46x 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 |
|---|---|---|
| Aetna | $260 - $372 | 143% |
| Wppa/Providrs Care- All Plans | $260 - $372 | 143% |
| Multiplan- All Plans | $265 - $380 | 146% |
| UnitedHealthcare | $265 | 146% |
| Health Partners - All Plans | $265 - $380 | 146% |
Consumer Guidance & Cost Commentary
For this psychotherapy session at Clay County Medical Center in Clay Center, KS, the cash price of $340.00 is significantly higher than the facility's negotiated rate of $265.00, which aligns with the median negotiated amount across all payers. While the gross charge listed is $340.00, commercial insurance plans typically pay between $260 and $380 depending on the specific carrier, with UnitedHealthcare paying the lowest amount at $265.00. It is important to note that for patients with high-deductible plans, paying the cash price of $340.00 upfront might actually be more cost-effective than using insurance, as the insurer's allowed amount often exceeds the cash rate due to administrative overheads included in the negotiated contracts.
The facility's pricing is benchmarked against the Medicare rate of $181.34, showing a markup factor of 1.5 times the Medicare amount. This aligns with the general industry standard where commercial negotiated rates average 200% to 300% of Medicare, though fair pricing is often defined as 120% to 150%. To minimize costs, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the final bill by 20% to 50%. Additionally, if you receive a bill after using insurance, request a full itemized audit to ensure no errors exist, as over 80% of hospital bills contain mistakes such as double-billing or unbundled codes that can be corrected to lower your out-of-pocket expenses.