CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Essentia Health St Mary's Medical Center

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $161
  • Cash Discount Price: $193
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Essentia Health St Mary's Medical Center is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.89x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$193

Average discount available for prompt cash payment at this facility.

Insurance Median
$161

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: $193 (106%)
Insurance Median: $161 (89%)
Cash: $193 (106% of Medicare)
Ins. Median: $161 (89% 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.

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
Medica Access $97 53%
Healthpartners Care Pmap $116 64%
Sanford Health Plan $125 - $285 69%
Blue Cross Blue Shield $129 - $368 71%
Blue Plus Pmap Pcc Prime $129 - $146 71%
Primewest $154 85%
Advocare/Security Health $161 89%
Freedom Blue Ppo $161 89%
Healthpartners Care Msho / Mcr Adv $161 89%
Imcare Msho (Ref Req) $161 89%
Imcare Msho Pcc Prime $161 89%
Imcare Msho Ref Req $161 89%
Itasca Med Care $161 89%
Medica $161 - $166 89%
Medica Advantage Solutions $161 89%
Medica Msho/Dual Solutions $161 89%
Medica Prime Solution Group $161 89%
Medica Uplan $161 89%
Medicare (plans) $161 89%
Nd Va Administration $161 89%
Platinum Blue / Vantage Blue $161 89%
Primewest Msho $161 89%
Secure Blue Msho $161 89%
Ubh Cost Plan $161 89%
Ubh Msho $161 89%
Ucare Msho $161 89%
UnitedHealthcare $161 - $214 89%
Healthpartners $175 - $209 97%
Medica Choice $178 98%
Ucare $192 106%
Cigna $209 115%
Healthpartners Pcc Prime $209 115%
Wea $210 - $225 116%
Security Health $225 124%
America'S Ppo $226 125%
Wps $242 - $245 133%
Aetna $248 137%
Healthscope Benefits $248 137%
Healtheos $251 138%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals