CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Licking Memorial Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $237
Cash Discount Price: $264
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Licking Memorial Hospital is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $264. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.31x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.

Cash / Self-Pay

$264

Average discount available for prompt cash payment at this facility.

Insurance Median

$237

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: $264 (146%)

Insurance Median: $237 (131%)

Cash: $264 (146% of Medicare)

Ins. Median: $237 (131% 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
Medical Mutual [100114]	$145 - $219	80%
Blue Cross Blue Shield	$169 - $227	93%
Medben [700068]	$185 - $258	102%
Benicomp [70090]	$198	109%
Consociate Health 6 Degrees [100059]	$211	116%
Consociate Health [100029]	$211	116%
Aetna	$216 - $218	119%
Allied Benefit Systems [100015]	$216	119%
Geha [100039]	$216	119%
Gravie Administrative Services [100165]	$216	119%
Meritain [100063]	$216	119%
Optima [700069]	$216	119%
Trustmark Small Business Benefits [100263]	$216	119%
Webtpa [100127]	$216	119%
American Postal Workers [100089]	$237	131%
Antidote Health Plan Of Ohio [70006803]	$237	131%
Cigna	$237	131%
Coresource [100002]	$237 - $264	131%
Great West Life [700064]	$237	131%
National Association Of Letter Carriers [100067]	$237	131%
Ohio Healthy Luminare Health [100264]	$237	131%
Ohio Healthy [100255]	$237	131%
Ohio Ppo Connect [70006801]	$237	131%
Osu Prime Care [100254]	$237	131%
Quality Care Partners [70006802]	$237	131%
The Health Plan [100261]	$237	131%
Wellfleet Group, Llc [100164]	$237	131%
Coventry [100010]	$243	134%
Pan American Life [700070]	$243	134%
Ohio Health Choice [100109]	$253	140%
Administrative Concepts [100006]	$256	141%
Carefactor [100087]	$256	141%
Humana	$256	141%
Philadelphia American Life [100260]	$256 - $264	141%
Reliance Standard-Asrm [100258]	$256	141%
Healthscope [100157]	$264	146%
Surest [100016]	$264	146%
United Medical Resources [700071]	$264	146%
UnitedHealthcare	$264	146%

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 $264.
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 Licking Memorial 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.