CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Mercy Hospital of Buffalo

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $138
  • Cash Discount Price: $255
  • vs. Medicare Baseline: 0.76x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Mercy Hospital of Buffalo is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $255. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.76x the Medicare baseline. Located in 565 Abbott Road, Buffalo, NY.
Cash / Self-Pay
$255

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

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: $255 (141%)
Insurance Median: $138 (76%)
Cash: $255 (141% of Medicare)
Ins. Median: $138 (76% 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 $53 - $156 29%
Mvp Healthcare [100168] $80 - $173 44%
UnitedHealthcare $92 - $153 51%
Medicaid / KanCare $102 - $150 56%
Excellus Rochester McD [350117] $106 - $128 58%
Independent Health Essential [100166] $106 - $128 58%
Vna Option Mltc [350110] $106 - $128 58%
Amerigroup [350102] $106 - $128 58%
Tuscarora Nation [550120] $106 - $128 58%
Crime Victims [100176] $106 - $128 58%
UPMC Health Plan [100181] $109 - $237 60%
Univera Healthcare Essential [100170] $109 - $123 60%
Univera Healthcare [100169] $109 - $181 60%
Beacon Essential [350122] $118 - $158 65%
VA Veterans Affairs [700001] $118 - $150 65%
Medicare (plans) $129 - $157 71%
Hospice [550001] $132 - $150 73%
Fallon Health [450115] $132 - $150 73%
Cigna $132 - $217 73%
Champ VA [700002] $132 - $150 73%
Catholic Health Life Pace [400005] $132 - $150 73%
Tricare $132 - $150 73%
Covid19 Hrsa [45013] $132 - $150 73%
Seneca Nation [450119] $132 - $150 73%
Fidelis Essential [100163] $135 - $180 74%
Wellcare Fidelis Dual [450451] $138 - $157 76%
Fidelis Dual Advantage [450120] $138 - $157 76%
Humana $138 - $150 76%
Aetna $138 - $150 76%
Ghi [100153] $145 - $165 80%
Wellcare [450129] $145 - $165 80%
Magnacare [100142] $150 83%
Meritain [100063] $150 83%
Independent Health [100165] $151 - $171 83%
Iha First Choice [800001] $151 - $171 83%
Beacon Health Options [100023] $158 87%
Fidelis Exchange [100164] $158 - $180 87%
No Fault [114001] $225 124%
Federal Workers Compensation [500100] $225 124%
Molina Essential [100167] $239 - $288 132%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 565 Abbott Road, Buffalo, NY 14220
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals