CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $167
Cash Discount Price: $215
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Munson Healthcare Otsego Memorial Hospital is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $215. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.92x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$215

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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: $215 (119%)

Insurance Median: $167 (92%)

Cash: $215 (119% of Medicare)

Ins. Median: $167 (92% 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
Mclaren Health Plan	$60 - $212	33%
Meridian	$60 - $92	33%
Molina	$60 - $191	33%
Priority Health	$60 - $227	33%
UnitedHealthcare	$60 - $203	33%
Blue Cross Blue Shield	$61 - $158	34%
Blue Care Network	$91 - $177	50%
Hap (Health Alliance Plan)	$91 - $202	50%
Humana	$91 - $177	50%
Medicare (plans)	$91 - $177	50%
Michigan Amish Medical Board	$91 - $177	50%
Northern Michigan Mennonite Group	$91 - $177	50%
Aetna	$92 - $205	51%
Cigna	$117 - $227	65%
Asr Physicians Care Network	$137 - $202	76%
Nomi Health	$146 - $202	81%
Hospice Of Michigan	$152	84%
Employee Benefit Logistics	$155 - $301	85%
Munson Hospice	$177 - $852	98%
Enterprise Group Planning/Employee Benefit Plan	$202	111%
Cofinity	$215	119%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$215	119%
Three Rivers Provider Network	$215	119%

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 $215.
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 Munson Healthcare Otsego Memorial Hospital 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.