CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Breckinridge Memorial Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $190
Cash Discount Price: $264
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Breckinridge Memorial Hospital is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $264. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.05x the Medicare baseline. Located in 1011 Old Highway 60, Hardinsburg, KY.

Cash / Self-Pay

$264

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

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: $264 (146%)

Insurance Median: $190 (105%)

Cash: $264 (146% of Medicare)

Ins. Median: $190 (105% 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
Aetna	$94 - $396	52%
Blue Cross Blue Shield	$94 - $528	52%
Wellcare Mcaid - All Other Plans	$94	52%
Tricare	$171	94%
Molina Mcr Adv - All Plans	$183	101%
University Health Care - All Other Plans	$185	102%
Caresource - All Plans	$190	105%
University Health Care Mcr Adv	$190	105%
Wellcare Mcr Adv	$190	105%
Ambetter / Centene	$209	115%
Humana	$396	218%
UnitedHealthcare	$449	248%

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 $264.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90837.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Breckinridge Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90837.
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.