Psychotherapy session (60 minutes)
Facility: Fredonia Regional Hospital
Billing Code: 90837 (CPT)
- CPT Billing Code: 90837
- Insurance Median: $148
- Cash Discount Price: $272
- vs. Medicare Baseline: 0.82x 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 |
|---|---|---|
| Blue Cross Blue Shield | $127 - $361 | 70% |
| Veterans Programs - All Plans | $134 - $195 | 74% |
| UnitedHealthcare | $134 - $344 | 74% |
| Aetna | $134 - $344 | 74% |
| Cigna | $145 - $344 | 80% |
| Reserve National-All Plans | $145 - $344 | 80% |
| Meritain-All Plans | $145 - $344 | 80% |
Consumer Guidance & Cost Commentary
For CPT code 90837, a 60-minute psychotherapy session at Fredonia Regional Hospital in Fredonia, Kansas, the cash price is $272.00, which matches the facility's median negotiated rate of $145.00 and the cash median. This cash price is significantly higher than the Medicare benchmark of $181.34, reflecting a markup common in commercial billing where rates often average 200% to 300% of the federal baseline. While the facility is a Critical Access Hospital with government local ownership, patients should note that commercial negotiated rates for this service range from $127 to $361 across seven payers, including Blue Cross Blue Shield and UnitedHealthcare. Because the cash price exceeds the Medicare rate, paying out-of-pocket may not be the most economical option for those with high-deductible plans, as the insurance negotiated rate of $145.00 is lower than the cash price.
To minimize costs, patients should verify if the hospital offers self-pay or prompt-pay discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing administrative fees associated with insurance claims. It is important to request a waiver of insurance submission before check-in to ensure the cash rate applies, as automatic claims processing can void such agreements. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still review their itemized bills to ensure no unbundled codes or services not rendered are included. Given that over 80% of hospital bills contain errors, requesting a formal itemized audit is a critical step