CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: St Mary's Healthcare

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90834
  • Insurance Median: $159
  • Cash Discount Price: $128
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at St Mary's Healthcare is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.88x the Medicare baseline. Located in 427 Guy Park Avenue, Amsterdam, NY.
Cash / Self-Pay
$128

Average discount available for prompt cash payment at this facility.

Insurance Median
$159

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: $128 (71%)
Insurance Median: $159 (88%)
Cash: $128 (71% of Medicare)
Ins. Median: $159 (88% 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
Blue Cross Blue Shield $82 - $497 45%
Carelon_Empire $82 - $383 45%
Carelon_Commercial $85 - $398 47%
Excellus_Commercial $101 - $613 56%
Aetna $102 - $622 56%
Emblem_Commercial $102 - $622 56%
Cdphp_Commercial $125 69%
Medicaid / KanCare $134 - $150 74%
UnitedHealthcare $134 74%
Humana $136 - $233 75%
Medicare (plans) $136 - $248 75%
Va $136 - $222 75%
Tricare $222 122%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 427 Guy Park Avenue, Amsterdam, NY 12010
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals