Psychotherapy session (45 minutes)
Facility: Girard Medical Center
Billing Code: 90834 (CPT)
- CPT Billing Code: 90834
- Insurance Median: $114
- Cash Discount Price: $195
- vs. Medicare Baseline: 0.63x 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 | $100 - $114 | 55% |
| Medicare (plans) | $114 | 63% |
| Ambetter / Centene | $114 | 63% |
| Humana | $114 | 63% |
| Aetna | $114 - $569 | 63% |
| Kansas Superior Select-All Plans | $114 | 63% |
| UnitedHealthcare | $114 | 63% |
| Multiplan-All Plans | $301 | 166% |
Consumer Guidance & Cost Commentary
For a psychotherapy session at Girard Medical Center in Kansas, the negotiated rates for in-network payers average $114, which aligns closely with the facility's median negotiated amount and the lowest commercial rates observed among the eight insurers. This rate is significantly lower than the facility's gross charge of $325, but it remains higher than the cash price of $195. While the facility is a Critical Access Hospital in a rural area, the negotiated rate of $114 is comparable to the Medicare benchmark of $181.34, suggesting the commercial pricing is within a reasonable range relative to the federal baseline. Patients with high-deductible plans may find the cash price of $195 more advantageous than the insurance negotiated rate of $114, provided they have not yet met their out-of-pocket deductible, as paying the cash price upfront can sometimes result in lower total costs than the administrative overhead embedded in insurance billing.
It is important to note that while the facility is in-network for most major insurers, the wide range of allowed amounts for Aetna ($114 to $569) highlights that not all commercial rates are uniform, and the "in-network" status does not guarantee the lowest possible price. To potentially reduce costs further, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can offer a fee reduction of 20% to 50% for upfront payment. Additionally, since over 80% of hospital bills contain errors, consumers are encouraged to request a detailed, itemized bill rather than accepting a summary invoice, ensuring that all charges correspond exactly to services rendered. Always verify your specific deductible status