CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Boston Children's Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $533
Cash Discount Price: $748
vs. Medicare Baseline: 2.94x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Boston Children's Hospital is $533. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $748. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.94x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$748

Average discount available for prompt cash payment at this facility.

Insurance Median

$533

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: $748 (412%)

Insurance Median: $533 (294%)

Cash: $748 (412% of Medicare)

Ins. Median: $533 (294% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 294% of the Medicare baseline (a markup of 194%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Cdphp	$287 - $774	158%
Harvard Pilgrim	$297 - $616	164%
Blue Cross Blue Shield	$330 - $601	182%
United	$350 - $761	193%
Aetna	$351 - $764	194%
Mgb/Allways	$356 - $674	196%
Tufts Public Plan	$359 - $561	198%
United Ri Nj Ny	$369 - $574	203%
Ambetter / Centene	$370 - $576	204%
Carelon Strategies/Bhs	$380 - $592	210%
UnitedHealthcare	$380 - $774	210%
Carelon/Beacon	$439 - $683	242%
Fallon	$446 - $702	246%
Health New England	$473 - $736	261%
Cigna	$497 - $911	274%
Ets/Lifetrac	$497 - $774	274%
Interlink Transplant	$497 - $774	274%
Community Health Options	$526 - $820	290%
Humana	$526 - $820	290%
Coventry/Hcvm/First Health	$538 - $838	297%
Multiplan/Phcs	$538 - $865	297%

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 $748.
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 Boston Children's 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.