CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Sparrow Ionia Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $134
Cash Discount Price: $46
vs. Medicare Baseline: 0.74x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Sparrow Ionia Hospital is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.74x the Medicare baseline. Located in 3565 S State Road, Ionia, MI.

Cash / Self-Pay

$46

Average discount available for prompt cash payment at this facility.

Insurance Median

$134

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: $46 (25%)

Insurance Median: $134 (74%)

Cash: $46 (25% of Medicare)

Ins. Median: $134 (74% 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	$46 - $190	25%
Covenant Advantage	$46 - $104	25%
Medicare (plans)	$46 - $110	25%
Medigold	$46 - $104	25%
Senior Community Care	$46 - $104	25%
Humana	$49 - $150	27%
Medicaid / KanCare	$61 - $199	34%
Priority	$104 - $114	57%
Blue Cross Blue Shield	$106 - $181	58%
UnitedHealthcare	$130 - $142	72%
Cigna	$134 - $147	74%
Great West Healthcare	$134 - $147	74%
Asr	$135 - $148	74%
Blue Care Network	$135 - $148	74%
Health Alliance Plan	$135 - $148	74%
Cofinity	$137 - $150	76%
Mclaren Commercial	$151 - $165	83%
Priority Health Medihmo	$181	100%

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 $46.
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 Sparrow Ionia 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.