CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Essentia Health Virginia

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $158
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Essentia Health Virginia is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.87x the Medicare baseline. Located in 901 9Th Street North, Virginia, MN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$158

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%)

Insurance Median: $158 (87%)

Ins. Median: $158 (87% 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
Primewest	$154	85%
Advocare/Security Health	$158	87%
Blue Cross Blue Shield	$158 - $567	87%
Freedom Blue Ppo	$158	87%
Healthpartners Care Msho / Mcr Adv	$158	87%
Imcare Msho Pcc Prime	$158	87%
Imcare Msho Ref Req	$158	87%
Medica Advantage Solutions	$158	87%
Medica Msho/Dual Solutions	$158	87%
Medica Prime Solution Group	$158	87%
Medicare (plans)	$158	87%
Nd Va Administration	$158	87%
Platinum Blue/Vantage Blue	$158	87%
Primewest Msho	$158	87%
Secure Blue Msho	$158	87%
Ubh Cost Plan	$158	87%
Ubh Msho	$158	87%
Ucare Msho	$158	87%
UnitedHealthcare	$158	87%
Itasca Med Care	$161	89%
Sanford Healthplan	$285	157%

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 $X.
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 Essentia Health Virginia 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.