CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Merit Health Madison

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $314
Cash Discount Price: $131
vs. Medicare Baseline: 1.73x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Merit Health Madison is $314. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.73x the Medicare baseline. Located in 161 River Oaks Drive, Canton, MS.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$314

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: $131 (72%)

Insurance Median: $314 (173%)

Cash: $131 (72% of Medicare)

Ins. Median: $314 (173% 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
Ms-Can-Molina	$126	69%
Ms-Can-Magnolia	$127	70%
Ms-Can-Truecare	$129	71%
Medicare (plans)	$160	88%
Wellcare	$165	91%
Humana	$167	92%
Devoted_Health	$168	93%
Molina-Chip	$269	148%
Magnolia-Chip	$275	152%
Truecare-Chip	$275	152%
Mpcn	$313	173%
Advhealth	$316 - $340	174%
Ambetter / Centene	$316 - $340	174%
Blue Cross Blue Shield	$316 - $340	174%
Cigna	$316 - $340	174%
Molina_Exchange	$316 - $340	174%
Firstchoice	$321	177%

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 $131.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90837.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Merit Health Madison is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90837.
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.