CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Mercy Hospital Ada

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $250
Cash Discount Price: $270
vs. Medicare Baseline: 1.38x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Mercy Hospital Ada is $250. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $270. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.38x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.

Cash / Self-Pay

$270

Average discount available for prompt cash payment at this facility.

Insurance Median

$250

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: $270 (149%)

Insurance Median: $250 (138%)

Cash: $270 (149% of Medicare)

Ins. Median: $250 (138% 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
Blue Cross Blue Shield	$90 - $161	50%
Aetna	$94 - $313	52%
Humana	$94	52%
Medicaid / KanCare	$94	52%
Healthcare Highways Plus Contracted [320175]	$162 - $312	89%
Webtpa Contracted [320417]	$175	97%
Osma Health Contracted [320292]	$187	103%
UnitedHealthcare	$191 - $291	105%
Medica Contracted [320239]	$194 - $416	107%
Benefit Management Contracted [320052]	$208 - $270	115%
Aither Health Contracted [320449]	$250	138%
Auxiant Contracted [320462]	$250	138%
Ebms Contracted [320493]	$250	138%
Federal Medical Center Contracted [320127]	$250	138%
Healthlink Contracted [320179]	$250	138%
Healthscope Contracted [320182]	$250	138%
Imagine 360 Contracted [320494]	$250	138%
Mercy Benefit Admin Contracted [320251]	$250 - $270	138%
Point C Contracted [320238]	$250	138%
Preferred Health Plan Contracted [320522]	$250	138%
Quik Trip Contracted [320447]	$250	138%
Reflect Health Contracted [320492]	$250	138%
Show-Me Health Administrators Contracted [320483]	$250	138%
United Medical Resources Contracted [320454]	$250 - $291	138%
Workers Comp [20426]	$250	138%
Yuzu Health Contracted [320521]	$250	138%
Globalhealth Contracted [320144]	$262	144%
Health Choice Contracted [320166]	$321	177%
First Health Contracted [320128]	$346	191%
Multiplan Contracted [320270]	$354	195%
Private Health Care Systems Contracted [320320]	$354	195%
Medicare (plans)	$416	229%

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 $270.
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 Mercy Hospital Ada 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.