CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Glens Falls Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $99
Cash Discount Price: $154
vs. Medicare Baseline: 0.55x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Glens Falls Hospital is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $154. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.55x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.

Cash / Self-Pay

$154

Average discount available for prompt cash payment at this facility.

Insurance Median

$99

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: $154 (85%)

Insurance Median: $99 (55%)

Cash: $154 (85% of Medicare)

Ins. Median: $99 (55% 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	$32 - $87	18%
Cdphp	$61 - $447	34%
Emblem Health Ghi	$67 - $103	37%
Medicare (plans)	$67 - $103	37%
Tricare	$67 - $103	37%
UnitedHealthcare	$67 - $144	37%
Mvp	$75 - $417	41%
Blue Cross Blue Shield	$77 - $199	42%
Cigna	$79 - $158	44%
Blue Shield Highmark	$87 - $107	48%
Aetna	$90 - $295	50%
Fidelis	$90 - $447	50%
Blue Shield	$136 - $246	75%
Hamaspik	$164 - $237	90%
Nascentia Health Options	$164 - $237	90%
Magnacare	$190 - $274	105%
Emblem	$202 - $292	111%
Empire Plan Nyship	$214 - $310	118%
Multiplan	$214 - $310	118%
Mvp Commercial	$365 - $422	201%

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 $154.
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 Glens Falls Hospital 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.