CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $177
Cash Discount Price: $247
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Munson Healthcare Otsego Memorial Hospital is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $247. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.98x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$247

Average discount available for prompt cash payment at this facility.

Insurance Median

$177

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: $247 (136%)

Insurance Median: $177 (98%)

Cash: $247 (136% of Medicare)

Ins. Median: $177 (98% 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	$89 - $244	49%
Meridian	$89 - $92	49%
Molina	$89 - $191	49%
Priority Health	$89 - $227	49%
UnitedHealthcare	$89 - $233	49%
Blue Cross Blue Shield	$90 - $182	50%
Blue Care Network	$135 - $177	74%
Hap (Health Alliance Plan)	$135 - $233	74%
Humana	$135 - $177	74%
Medicare (plans)	$135 - $177	74%
Michigan Amish Medical Board	$135 - $177	74%
Northern Michigan Mennonite Group	$135 - $177	74%
Aetna	$136 - $236	75%
Cigna	$174 - $227	96%
Hospice Of Michigan	$175	97%
Asr Physicians Care Network	$202 - $233	111%
Munson Hospice	$204 - $852	112%
Nomi Health	$215 - $233	119%
Employee Benefit Logistics	$229 - $301	126%
Enterprise Group Planning/Employee Benefit Plan	$233	128%
Cofinity	$247	136%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$247	136%
Three Rivers Provider Network	$247	136%

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 $247.
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 Munson Healthcare Otsego 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.