CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Kenmore Mercy Hospital

Billing Code: 90834 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$115

about 0.6× the $181 Medicare rate · typically $102–$143

modeled estimate · not a bill or quote

What this hospital charges insurers

$102

Below the fair price — a good deal

about $13 under the fair price · 0.6× Medicare

Medicare pays $181 Fair price $115 This hospital $102 Cash price $287 Hospital's list price $287

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $68 Priciest $102

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Psychotherapy session (45 minutes) is about $115 (about 0.6× the $181 Medicare rate). Kenmore Mercy Hospital charges insurers about $102, or about $287 in cash — below the fair price — a good deal. Located in Kenmore, NY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$62 - $92	34%
Blue Cross Blue Shieldmajor	$36 - $104	20%
Aetnamajor	$94	52%
Cignamajor	$89 - $129	49%
Humanamajor	$94	52%
Amerigroup	$71	39%
Fidelis Care	$94 - $107	52%
Independent Health	$71 - $102	39%
Molina	$160	88%
MVP Health Care	$73 - $104	40%
UPMC Health Plan	$160	88%
WellCare	$94 - $98	52%
+ 16 smaller / regional plans	$71 - $150

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 287), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90834.

Insurance Before you use insurance

Call your insurance company to confirm Kenmore Mercy Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 90834.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Kenmore Mercy Hospital

Compare: Psychotherapy session (45 minutes) at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.