CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Pine Rest Christian Mental Health Services

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $90
Cash Discount Price: $115
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Pine Rest Christian Mental Health Services is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.50x the Medicare baseline. Located in 300 - 68Th Street, Se, Grand Rapids, MI.

Cash / Self-Pay

$115

Average discount available for prompt cash payment at this facility.

Insurance Median

$90

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: $115 (63%)

Insurance Median: $90 (50%)

Cash: $115 (63% of Medicare)

Ins. Median: $90 (50% 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	$43 - $79	24%
UnitedHealthcare	$43 - $139	24%
Aetna	$58 - $173	32%
Blue Cross Blue Shield	$58 - $135	32%
Perspectives [1191]	$65	36%
Champva [1117]	$67 - $101	37%
Humana	$67 - $112	37%
Medicare (plans)	$67 - $101	37%
Molina [1156]	$67 - $101	37%
Tricare	$67 - $101	37%
Veterans Administration [1174]	$67 - $101	37%
Bensinger Dupont [1179]	$70	39%
Human Mgmt/Health Advocate [1189]	$75	41%
Resolutions Eap [1211]	$75	41%
Ambetter / Centene	$80	44%
Beacon/Carelon Behavioral Health [1198]	$88 - $114	49%
Asr Physicians Care Health Plan [1160]	$89 - $119	49%
Hap Ppo/Health Alliance Plan [1134]	$89 - $119	49%
Cigna	$90 - $113	50%
Network 180 [3530]	$91 - $175	50%
University Of Michigan Health Plan Comm [1159]	$98 - $130	54%
University Of Michigan Health Plan [1205]	$98 - $130	54%
Blue Care Network [1000]	$100 - $143	55%
Golden Rule [1131]	$100 - $139	55%
Healthscope Benefits [1140]	$100 - $139	55%
Ubh [1167]	$100 - $139	55%
Behavioral Health Systems [1115]	$102 - $115	56%
Manistee Benzie County Cmh [3526]	$105	58%
Priority Health [1300]	$106 - $169	58%
Mclaren Health Plan [1149]	$121	67%
Compsych [1122]	$128 - $188	71%
Cofinity [1120]	$130 - $173	72%
Geha [1129]	$130 - $173	72%
Meritain Health Plan [1153]	$130 - $173	72%

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 $115.
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 Pine Rest Christian Mental Health Services 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.