CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Mercy Hospital Ada

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $283
Cash Discount Price: $307
vs. Medicare Baseline: 1.56x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Mercy Hospital Ada is $283. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $307. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.56x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.

Cash / Self-Pay

$307

Average discount available for prompt cash payment at this facility.

Insurance Median

$283

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: $307 (169%)

Insurance Median: $283 (156%)

Cash: $307 (169% of Medicare)

Ins. Median: $283 (156% 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	$134 - $161	74%
Aetna	$138 - $355	76%
Humana	$138	76%
Medicaid / KanCare	$138	76%
Healthcare Highways Plus Contracted [320175]	$184 - $354	101%
Webtpa Contracted [320417]	$198	109%
Osma Health Contracted [320292]	$212	117%
UnitedHealthcare	$217 - $330	120%
Medica Contracted [320239]	$220 - $472	121%
Benefit Management Contracted [320052]	$236 - $307	130%
Aither Health Contracted [320449]	$283	156%
Auxiant Contracted [320462]	$283	156%
Ebms Contracted [320493]	$283	156%
Federal Medical Center Contracted [320127]	$283	156%
Healthlink Contracted [320179]	$283	156%
Healthscope Contracted [320182]	$283	156%
Imagine 360 Contracted [320494]	$283	156%
Mercy Benefit Admin Contracted [320251]	$283 - $307	156%
Point C Contracted [320238]	$283	156%
Preferred Health Plan Contracted [320522]	$283	156%
Quik Trip Contracted [320447]	$283	156%
Reflect Health Contracted [320492]	$283	156%
Show-Me Health Administrators Contracted [320483]	$283	156%
United Medical Resources Contracted [320454]	$283 - $330	156%
Workers Comp [20426]	$283	156%
Yuzu Health Contracted [320521]	$283	156%
Globalhealth Contracted [320144]	$297	164%
Health Choice Contracted [320166]	$321	177%
First Health Contracted [320128]	$392	216%
Multiplan Contracted [320270]	$401	221%
Private Health Care Systems Contracted [320320]	$401	221%
Medicare (plans)	$472	260%

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 $307.
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 Mercy Hospital Ada 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.