CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: North Carolina Baptist Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $77
Cash Discount Price: $111
vs. Medicare Baseline: 0.42x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at North Carolina Baptist Hospital is $77. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.42x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$77

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: $111 (61%)

Insurance Median: $77 (42%)

Cash: $111 (61% of Medicare)

Ins. Median: $77 (42% 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
Medcost	$43 - $152	24%
Blue Cross Blue Shield	$45 - $156	25%
Amerihealth	$49 - $61	27%
Carolina Complete	$49 - $52	27%
Health Blue	$49 - $52	27%
Partners	$49 - $52	27%
UnitedHealthcare	$49 - $156	27%
Vaya	$49 - $52	27%
Wellcare	$49 - $156	27%
Alliance	$50 - $53	28%
Trillium	$50 - $53	28%
Aetna	$51 - $194	28%
Ambetter / Centene	$58 - $62	32%
Oscar	$65 - $82	36%
Cigna	$66 - $156	36%
Humana	$118 - $157	65%
Directnet	$128 - $135	71%
Cone Health	$151 - $160	83%
Healthgram	$151 - $160	83%
Apex	$156	86%
Devoted	$156	86%
Healthteam	$156	86%
Medicare (plans)	$157	87%
First Carolina Care	$173 - $182	95%
Private Healthcare Systems	$177 - $187	98%
Liberty	$179	99%
Multiplan	$194 - $205	107%

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 $111.
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 North Carolina Baptist Hospital 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.