CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Mercy Hospital Washington

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $167
Cash Discount Price: $265
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Mercy Hospital Washington is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $265. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.92x the Medicare baseline. Located in 901 East 5Th Street, Washington, MO.

Cash / Self-Pay

$265

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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: $265 (146%)

Insurance Median: $167 (92%)

Cash: $265 (146% of Medicare)

Ins. Median: $167 (92% 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	$25 - $226	14%
Aetna	$58 - $150	32%
Blue Cross Blue Shield	$88 - $430	49%
Medica Contracted [320239]	$101 - $112	56%
Ambetter / Centene	$104 - $116	57%
Home State Health Plan Contracted [320187]	$104 - $116	57%
Novasys Contracted [320285]	$104 - $116	57%
Aither Health Contracted [320449]	$151 - $167	83%
Aither Health [20449]	$151 - $167	83%
Auxiant Contracted [320462]	$151 - $167	83%
Ebms Contracted [320493]	$151 - $167	83%
Edison Health Solutions Contracted [320502]	$151 - $167	83%
Healthlink Contracted [320179]	$151 - $292	83%
Imagine 360 Contracted [320494]	$151 - $167	83%
Mercy Benefit Admin Contracted [320251]	$151 - $214	83%
Mercy Benefit Admin [20251]	$151 - $214	83%
Reflect Health Contracted [320492]	$151 - $167	83%
Show-Me Health Administrators Contracted [320483]	$151 - $167	83%
Yuzu Health Contracted [320521]	$151 - $167	83%
Cigna	$174 - $326	96%
UnitedHealthcare	$178	98%
Health Choices Contracted [320448]	$232 - $257	128%
Health Choices [20448]	$232 - $257	128%
Medical Associates Health Contracted [320444]	$232 - $257	128%
Federal Medical Center Contracted [320127]	$251 - $279	138%
Insurance System Inc Contracted [320465]	$251 - $279	138%
Point C Contracted [320238]	$251 - $279	138%
Tri State Healthcare Coalition Contracted [320379]	$251 - $279	138%
First Health Contracted [320128]	$270 - $305	149%
Mercy Mgd Behavioral Health Contracted [320259]	$270 - $300	149%
Multiplan Contracted [320270]	$270 - $322	149%
Private Health Care Systems Contracted [320320]	$270 - $300	149%
Workers Comp [20426]	$290 - $343	160%
Medicare (plans)	$386 - $486	213%

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 $265.
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 Washington 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.