CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Highland Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $254
Cash Discount Price: $449
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Highland Hospital is $254. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $449. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.40x the Medicare baseline. Located in 1000 South Avenue, Rochester, NY.

Cash / Self-Pay

$449

Average discount available for prompt cash payment at this facility.

Insurance Median

$254

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: $449 (248%)

Insurance Median: $254 (140%)

Cash: $449 (248% of Medicare)

Ins. Median: $254 (140% 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
Medicaid / KanCare	$41 - $2,239	23%
Amerigroup (Bswny Alternate) [1720]	$54 - $2,239	30%
Excellus [2201]	$54 - $254	30%
UnitedHealthcare	$54 - $2,239	30%
Aetna	$113 - $384	62%
Excellus Bc/Bs [2201]	$113 - $271	62%
Medicare (plans)	$113 - $263	62%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$116 - $505	64%
Elderplan [1316]	$133 - $152	73%
Icircle [1728]	$133 - $152	73%
Martins Point [1205]	$133 - $222	73%
Nascentia [1729]	$133 - $152	73%
Highmark Bc/Bs Of Western Ny [5143]	$134 - $158	74%
Humana	$134 - $243	74%
Molina Healthcare [5189], Molina Healthcare [1723]	$139 - $2,239	77%
Fidelis [5155]	$161 - $2,239	89%
Independent Health [5156]	$192 - $234	106%
Mvp [2900]	$201 - $1,124	111%
Blue Cross Blue Shield	$222 - $316	122%
Cigna	$307 - $715	169%
Capital District Physicians Health Plan (Cdphp) [5149]	$323 - $488	178%

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 $449.
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 Highland 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.