CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Sparrow Ionia Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $154
Cash Discount Price: $63
vs. Medicare Baseline: 0.85x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Sparrow Ionia Hospital is $154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.85x the Medicare baseline. Located in 3565 S State Road, Ionia, MI.

Cash / Self-Pay

$63

Average discount available for prompt cash payment at this facility.

Insurance Median

$154

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: $63 (35%)

Insurance Median: $154 (85%)

Cash: $63 (35% of Medicare)

Ins. Median: $154 (85% 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 - $154	25%
Medicare (plans)	$46 - $163	25%
Medigold	$46 - $154	25%
Senior Community Care	$46 - $154	25%
Humana	$49 - $202	27%
Medicaid / KanCare	$91 - $199	50%
Priority	$114 - $153	63%
Blue Cross Blue Shield	$116 - $200	64%
UnitedHealthcare	$142 - $192	78%
Cigna	$147 - $198	81%
Great West Healthcare	$147 - $198	81%
Asr	$148 - $200	82%
Blue Care Network	$148 - $200	82%
Health Alliance Plan	$148 - $200	82%
Cofinity	$150 - $202	83%
Mclaren Commercial	$165 - $223	91%
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 $63.
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 Sparrow Ionia 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.