CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Sanford Medical Center Fargo

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $178
Cash Discount Price: $258
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Sanford Medical Center Fargo is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $258. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.98x the Medicare baseline. Located in 801 Broadway North, Fargo, ND.

Cash / Self-Pay

$258

Average discount available for prompt cash payment at this facility.

Insurance Median

$178

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: $258 (142%)

Insurance Median: $178 (98%)

Cash: $258 (142% of Medicare)

Ins. Median: $178 (98% 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
Sanford Health Plan	$90	50%
Blue Cross Blue Shield	$116 - $282	64%
Health Partners	$132 - $165	73%
Medica	$145 - $155	80%
Sanford Health Plan Align	$153	84%
Ucare	$164 - $227	90%
Aetna	$165 - $276	91%
Medicare (plans)	$165	91%
UnitedHealthcare	$165 - $281	91%
Primewest	$167 - $169	92%
Security Health Plan	$178	98%
Cigna	$291	160%
First Choice Health Network	$291	160%
Healthez	$291	160%
Multiplan	$291	160%

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 $258.
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 Sanford Medical Center Fargo 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.