CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: St Claire Regional Medical Center

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $118
Cash Discount Price: $126
vs. Medicare Baseline: 0.65x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at St Claire Regional Medical Center is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.65x the Medicare baseline. Located in 222 Medical Circle, Morehead, KY.

Cash / Self-Pay

$126

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)

Cash / Self-Pay: $126 (69%)

Insurance Median: $118 (65%)

Cash: $126 (69% of Medicare)

Ins. Median: $118 (65% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Wellcare Mcaid	$39 - $295	22%
Medicaid / KanCare	$41 - $289	23%
Aetna	$63 - $289	35%
Beacon Bh - All Plans	$66	36%
Blue Cross Blue Shield	$85 - $200	47%
Caresource Mcr Adv	$91 - $184	50%
Humana	$91 - $184	50%
Healthlink - All Plans	$97 - $116	53%
Wellcare Comm - All Other Plans	$114 - $143	63%
Ky Health Co-Op - All Plans	$119 - $218	66%
Caresource Just4Me - All Other Plans	$128 - $239	71%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $126.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90834.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Claire Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90834.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.