CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: McKenzie Health System

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $158
Cash Discount Price: $192
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at McKenzie Health System is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.87x the Medicare baseline. Located in 120 N Delaware Street, Sandusky, MI.

Cash / Self-Pay

$192

Average discount available for prompt cash payment at this facility.

Insurance Median

$158

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: $192 (106%)

Insurance Median: $158 (87%)

Cash: $192 (106% of Medicare)

Ins. Median: $158 (87% 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
Medicaid / KanCare	$89	49%
Hap	$95	52%
Mclaren	$133	73%
United_Healthcare	$145	80%
Medicare (plans)	$149	82%
Aetna	$168	93%
Meritain	$168	93%
Priority_Health	$176	97%
Blue_Care_Network	$192	106%
Blue_Cross	$192	106%

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 $192.
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 McKenzie Health System 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.