Psychotherapy session (60 minutes)
Facility: Memorial Hospital
Billing Code: 90837 (CPT)
- CPT Billing Code: 90837
- Insurance Median: $227
- Cash Discount Price: $532
- vs. Medicare Baseline: 1.25x 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 | $41 - $160 | 23% |
| Tricare | $120 - $412 | 66% |
| Humana | $120 - $412 | 66% |
| Medicare (plans) | $121 - $416 | 67% |
| Ambetter / Centene | $132 - $453 | 73% |
| Coventry - All Other Plans | $215 - $742 | 119% |
| Preferred Healthcare-All Plans | $227 - $783 | 125% |
| Health Partners Of Kansas - All Plans | $227 - $783 | 125% |
| Wppa/Providers Care-All Plans | $335 - $1,153 | 185% |
Consumer Guidance & Cost Commentary
For a 60-minute psychotherapy session at Memorial Hospital in Abilene, KS, the cash price is $532.00, which matches the facility's median negotiated rate of $227.00 for most major payers. While the hospital's cash rate is significantly higher than the typical commercial negotiated rate of $227.00, it remains comparable to the state average for this service. Patients with high-deductible plans may find paying the full cash price of $532.00 more cost-effective than relying on insurance, as many commercial payers negotiate rates that can exceed the cash price due to administrative overhead and contract structures. To secure the lowest possible cost, patients should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront.
This facility is a Critical Access Hospital in Abilene, KS, and its pricing is benchmarked against the federal Medicare rate of $181.34 for this procedure. The commercial negotiated rates observed across nine payers range from $41 to $1,153, with most plans falling between $120 and $783. Because Medicare rates represent a scientifically validated baseline for the true cost of care, comparing the facility's rates to this benchmark reveals the markup applied by commercial insurers. If a patient receives care from an out-of-network provider at this facility, they should be aware of federal protections under the No Surprises Act, which ban balance billing for emergency and non-emergency services. If unexpected charges occur, patients can dispute the bill in writing to request an audit and