CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Golden Valley Memorial Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $161
  • Cash Discount Price: $340
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Golden Valley Memorial Hospital is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $340. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.89x the Medicare baseline. Located in 1600 N 2Nd St, Clinton, MO.
Cash / Self-Pay
$340

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: $340 (187%)
Insurance Median: $161 (89%)
Cash: $340 (187% 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
Home State Health $143 79%
UnitedHealthcare $143 - $274 79%
Aetna $161 89%
Humana $161 89%
Ambetter / Centene $194 107%

Consumer Guidance & Cost Commentary

For a psychotherapy session lasting 60 minutes at Golden Valley Memorial Hospital in Clinton, Missouri, the cash price of $340 is significantly lower than the facility's gross charge of $567, representing a substantial difference for patients paying out-of-pocket. This cash rate also stands in contrast to the Medicare benchmark of $181.34, which serves as the federal baseline for evaluating healthcare costs in the region. While the hospital is a government-owned acute care facility with a rating of 3, patients should be aware that commercial insurance negotiated rates can sometimes exceed the cash price; for instance, UnitedHealthcare members may face a negotiated rate as high as $274, whereas the cash option remains at $340.

Although the median negotiated rate across five payers is $161, which is lower than the cash price, patients with high-deductible plans might find the cash rate more beneficial if their insurance allowed amount exceeds $340. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected ancillary services like emergency care or specific lab tests could still trigger additional charges if providers are not contracted. To ensure the most accurate pricing, consumers should request an itemized bill to review CPT codes and verify that no unbundled charges or services not rendered have been included, as over 80% of hospital bills contain errors. Additionally, patients should explicitly ask about prompt-pay discounts before scheduling, as paying the full cash amount upfront can often result in a fee reduction that bypasses costly insurance claims processing.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 N 2Nd St, Clinton, MO 64735
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals