CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: The McDowell Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $259
Cash Discount Price: $625
vs. Medicare Baseline: 1.43x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at The McDowell Hospital is $259. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $625. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.43x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.

Cash / Self-Pay

$625

Average discount available for prompt cash payment at this facility.

Insurance Median

$259

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: $625 (345%)

Insurance Median: $259 (143%)

Cash: $625 (345% of Medicare)

Ins. Median: $259 (143% 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
Blue Cross Blue Shield	$83 - $247	46%
United	$85 - $321	47%
Wellcare	$86	47%
Amerihealth	$87	48%
Partners Health Management	$87	48%
Vaya Health	$87	48%
Apex Health	$125	69%
Cigna	$214 - $335	118%
Aetna	$230 - $452	127%
Oscar	$271	149%
Caresource	$275	152%
Medcost	$278 - $532	153%
Amerihealth Caritas	$294	162%
Ambetter / Centene	$330	182%
Magellan	$375	207%
Magellan Behavioral Health	$375	207%
Multiplan	$500	276%
Avalon Administrative Services	$532	293%
Prime Health	$550 - $563	303%

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 $625.
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 The McDowell 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.