Psychotherapy session (45 minutes)
Facility: Children'S Mercy South
Billing Code: 90834 (CPT)
- CPT Billing Code: 90834
- Insurance Median: $137
- Cash Discount Price: $125
- vs. Medicare Baseline: 0.76x 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 |
|---|---|---|
| UnitedHealthcare | $81 - $168 | 45% |
| Healthy Blue | $86 - $127 | 47% |
| Medicaid / KanCare | $87 | 48% |
| Healthlink | $102 | 56% |
| Wppa Providrs Care | $119 | 66% |
| Health Midwest Comprehensive Care | $120 | 66% |
| Home State Health | $127 | 70% |
| American Healthcare Alliance | $130 | 72% |
| Blue Cross Blue Shield | $137 | 76% |
| Medica | $152 | 84% |
| Humana | $153 | 84% |
| Orscheln | $155 | 85% |
| Nebraska Furniture Mart | $157 | 87% |
| Wellfit/Centrus | $166 | 92% |
| Cigna | $168 | 93% |
| Centivo | $171 | 94% |
| Mercy Health | $191 | 105% |
| Coxhealth Network | $193 | 106% |
| National Preferred Provider Network | $230 | 127% |
Consumer Guidance & Cost Commentary
For this psychotherapy session at Children's Mercy South in Overland Park, KS, the facility's cash price of $125.00 is significantly lower than the gross charge of $261.00. While the negotiated rates for in-network payers range from $81 to $230, the cash price offers a potential savings of up to $136 compared to the lowest negotiated rate. This aligns with the principle that cash-pay can sometimes be cheaper for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price. To maximize savings, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative costs associated with insurance claims processing.
The facility's cash rate of $125.00 is also notably lower than the Medicare benchmark of $181.34, which serves as a scientifically validated baseline for the true cost of care. Commercial negotiated rates often average 200% to 300% of Medicare, whereas fair pricing is typically defined as 120% to 150% of this benchmark. Because the cash price is well below the Medicare amount, it suggests the facility is pricing competitively relative to federal standards. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but they should still request an itemized bill to verify all charges and avoid unexpected costs from unbundled codes or services not rendered.