CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: St Mary's Healthcare

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $187
Cash Discount Price: $156
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at St Mary's Healthcare is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.03x the Medicare baseline. Located in 427 Guy Park Avenue, Amsterdam, NY.

Cash / Self-Pay

$156

Average discount available for prompt cash payment at this facility.

Insurance Median

$187

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: $156 (86%)

Insurance Median: $187 (103%)

Cash: $156 (86% of Medicare)

Ins. Median: $187 (103% 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
Carelon_Empire	$82	45%
Carelon_Commercial	$85	47%
Blue Cross Blue Shield	$112 - $228	62%
Cdphp_Commercial	$125	69%
Medicaid / KanCare	$134 - $150	74%
UnitedHealthcare	$134	74%
Excellus_Commercial	$138 - $229	76%
Aetna	$140 - $233	77%
Emblem_Commercial	$140 - $232	77%
Humana	$187 - $233	103%
Medicare (plans)	$187 - $248	103%
Va	$187 - $222	103%
Tricare	$222	122%

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 $156.
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 St Mary's Healthcare 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.