CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Pine Rest Christian Mental Health Services

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $120
Cash Discount Price: $160
vs. Medicare Baseline: 0.66x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Pine Rest Christian Mental Health Services is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.66x the Medicare baseline. Located in 300 - 68Th Street, Se, Grand Rapids, MI.

Cash / Self-Pay

$160

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

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: $160 (88%)

Insurance Median: $120 (66%)

Cash: $160 (88% of Medicare)

Ins. Median: $120 (66% 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	$64 - $97	35%
UnitedHealthcare	$64 - $145	35%
Perspectives [1191]	$65	36%
Bensinger Dupont [1179]	$70	39%
Human Mgmt/Health Advocate [1189]	$75	41%
Resolutions Eap [1211]	$75	41%
Blue Cross Blue Shield	$80 - $199	44%
Aetna	$85 - $254	47%
Network 180 [3530]	$91	50%
Beacon/Carelon Behavioral Health [1198]	$96 - $114	53%
Champva [1117]	$99 - $150	55%
Humana	$99 - $164	55%
Medicare (plans)	$99 - $150	55%
Molina [1156]	$99 - $150	55%
Tricare	$99 - $150	55%
Veterans Administration [1174]	$99 - $150	55%
Golden Rule [1131]	$106 - $145	58%
Healthscope Benefits [1140]	$106 - $145	58%
Ubh [1167]	$106 - $145	58%
Behavioral Health Systems [1115]	$109 - $120	60%
Ambetter / Centene	$110	61%
Cigna	$113 - $172	62%
Asr Physicians Care Health Plan [1160]	$125 - $167	69%
Hap Ppo/Health Alliance Plan [1134]	$125 - $167	69%
Compsych [1122]	$140 - $266	77%
University Of Michigan Health Plan Comm [1159]	$143 - $191	79%
University Of Michigan Health Plan [1205]	$143 - $191	79%
Blue Care Network [1000]	$147 - $183	81%
Priority Health [1300]	$161 - $258	89%
Mclaren Health Plan [1149]	$181	100%
Cofinity [1120]	$191 - $254	105%
Geha [1129]	$191 - $254	105%
Meritain Health Plan [1153]	$191 - $254	105%

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 $160.
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 Pine Rest Christian Mental Health Services 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.