CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $181
Cash Discount Price: $230
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Nationwide Children's Hospital Toledo, LLC is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $230. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.00x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$230

Average discount available for prompt cash payment at this facility.

Insurance Median

$181

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: $230 (127%)

Insurance Median: $181 (100%)

Cash: $230 (127% of Medicare)

Ins. Median: $181 (100% 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
Caresource	$51 - $190	28%
UnitedHealthcare	$51 - $1,408	28%
Amerihealth	$52 - $119	29%
Bchp	$52 - $119	29%
Mcclaren Health Plan - Michigan	$60 - $187	33%
Paramount	$91	50%
Blue Cross Blue Shield	$96 - $1,422	53%
Mmo	$96 - $976	53%
Tricare	$97	53%
Molina	$118 - $193	65%
Humana	$119	66%
Mcclaren Health Plan	$128 - $1,255	71%
Front Path Health Coalition	$139 - $1,255	77%
Cigna	$147 - $256	81%
Aetna	$148 - $1,074	82%
Ohc	$192 - $1,394	106%
Ohio Ppo Connect	$192 - $1,394	106%
First Health	$296 - $2,148	163%

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 $230.
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 Nationwide Children's Hospital Toledo, LLC 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.