CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Mercy Hospital Jefferson

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $151
Cash Discount Price: $251
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Mercy Hospital Jefferson is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $251. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.83x the Medicare baseline. Located in 1400 Us Highway 61, Crystal City, MO.

Cash / Self-Pay

$251

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $251 (138%)

Insurance Median: $151 (83%)

Cash: $251 (138% of Medicare)

Ins. Median: $151 (83% 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	$23 - $150	13%
Medicaid / KanCare	$23 - $226	13%
Medica Contracted [320239]	$40 - $112	22%
Ambetter / Centene	$42 - $116	23%
Home State Health Plan Contracted [320187]	$42 - $116	23%
Novasys Contracted [320285]	$42 - $116	23%
Aither Health Contracted [320449]	$60 - $167	33%
Aither Health [20449]	$60 - $167	33%
Auxiant Contracted [320462]	$60 - $167	33%
Ebms Contracted [320493]	$60 - $167	33%
Edison Health Solutions Contracted [320502]	$60 - $167	33%
Healthlink Contracted [320179]	$60 - $309	33%
Imagine 360 Contracted [320494]	$60 - $167	33%
Mercy Benefit Admin Contracted [320251]	$60 - $214	33%
Mercy Benefit Admin [20251]	$60 - $214	33%
Reflect Health Contracted [320492]	$60 - $167	33%
Show-Me Health Administrators Contracted [320483]	$60 - $167	33%
Yuzu Health Contracted [320521]	$60 - $167	33%
Cigna	$69 - $350	38%
Blue Cross Blue Shield	$73 - $430	40%
Health Choices Contracted [320448]	$92 - $257	51%
Health Choices [20448]	$92 - $257	51%
Medical Associates Health Contracted [320444]	$92 - $257	51%
Federal Medical Center Contracted [320127]	$100 - $279	55%
Insurance System Inc Contracted [320465]	$100 - $279	55%
Point C Contracted [320238]	$100 - $279	55%
Tri State Healthcare Coalition Contracted [320379]	$100 - $279	55%
First Health Contracted [320128]	$108 - $305	60%
Mercy Mgd Behavioral Health Contracted [320259]	$108 - $300	60%
Multiplan Contracted [320270]	$108 - $322	60%
Private Health Care Systems Contracted [320320]	$108 - $300	60%
Workers Comp [20426]	$116 - $343	64%
Medicare (plans)	$154 - $486	85%
UnitedHealthcare	$178	98%

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 $251.
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 Mercy Hospital Jefferson 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.