CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $184
Cash Discount Price: $269
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Nationwide Children's Hospital Toledo, LLC is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $269. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.01x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$269

Average discount available for prompt cash payment at this facility.

Insurance Median

$184

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: $269 (148%)

Insurance Median: $184 (101%)

Cash: $269 (148% of Medicare)

Ins. Median: $184 (101% 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	$78 - $190	43%
UnitedHealthcare	$79 - $227	44%
Amerihealth	$80 - $119	44%
Bchp	$80 - $119	44%
Mcclaren Health Plan - Michigan	$89 - $187	49%
Mmo	$112 - $262	62%
Molina	$118 - $193	65%
Blue Cross Blue Shield	$119 - $229	66%
Humana	$119	66%
Paramount	$135	74%
Tricare	$144	79%
Aetna	$173	95%
Front Path Health Coalition	$187 - $204	103%
Mcclaren Health Plan	$188 - $202	104%
Cigna	$218 - $382	120%
Ohc	$224 - $379	124%
Ohio Ppo Connect	$224 - $379	124%
First Health	$346	191%

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 $269.
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 Nationwide Children's Hospital Toledo, LLC 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.