CMS Price Transparency Data
Psychotherapy session (45 minutes)
Facility: St Charles Medical Center Prineville
Billing Code: 90834 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90834
- Insurance Median: $363
- Cash Discount Price: $335
- vs. Medicare Baseline: 2.00x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at St Charles Medical Center Prineville is $363. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $335. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.00x the Medicare baseline. Located in 384 Se Combs Flat Road, Prineville, OR.
Cash / Self-Pay
$335
Average discount available for prompt cash payment at this facility.
Insurance Median
$363
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: $335 (185%)
Insurance Median: $363 (200%)
Cash: $335 (185% of Medicare)
Ins. Median: $363 (200% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 200% of the Medicare baseline (a markup of 100%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 |
|---|---|---|
| Aetna | $117 - $365 | 65% |
| Ageright Advantage [142] | $117 | 65% |
| Champ Va [700] | $117 | 65% |
| Cigna | $117 - $264 | 65% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $117 | 65% |
| Devoted Health Inc [145] | $117 | 65% |
| Health Market Care Assured [134] | $117 | 65% |
| Health Net Med Adv [135] | $117 | 65% |
| Humana | $117 | 65% |
| Indian Health [704] | $117 | 65% |
| Kaiser Permanente Med Adv [136] | $117 | 65% |
| Law Enforcement [701] | $117 - $208 | 65% |
| Medicare (plans) | $117 - $136 | 65% |
| Samaritan Health Plan Med Adv [141] | $117 | 65% |
| Unicare [133] | $117 | 65% |
| UnitedHealthcare | $117 | 65% |
| Veterans [706] | $117 | 65% |
| Wellcare [132] | $117 | 65% |
| Tricare | $128 | 71% |
| Blue Cross Blue Shield | $129 - $522 | 71% |
| Advanced Health [534] | $147 | 81% |
| Allcare Health Plan [538] | $147 | 81% |
| Cascade Health Alliance [532] | $147 | 81% |
| Columbia Pacific Coordinated Care Llc [539] | $147 | 81% |
| Health Share Care Oregon [526] | $147 | 81% |
| Health Share Kaiser [543] | $147 | 81% |
| Health Share Ohsu Ohp [552] | $147 | 81% |
| Health Share Providence [548] | $147 | 81% |
| Health Share [537] | $147 | 81% |
| Intercommunity Health [530] | $147 | 81% |
| Jackson Care Connect [542] | $147 | 81% |
| Medicaid / KanCare | $147 | 81% |
| Primary Health Of Jospehine County Llc [547] | $147 | 81% |
| Umpqua Health [533] | $147 | 81% |
| Willamette Valley Community Health [536] | $147 | 81% |
| Yamhill County Coordinated Care Org [550] | $147 | 81% |
| Pacificsource [345] | $168 - $229 | 93% |
| Us Benefits [326] | $264 | 146% |
| Providence Health Plan [347] | $294 - $367 | 162% |
| Rocky Mountain Administrators [405] | $335 | 185% |
| Rx Internal [4100003] | $343 | 189% |
| Moda [310] | $361 | 199% |
| First Choice Health [317] | $363 | 200% |
| Kaiser Permanente [334] | $363 | 200% |
| Samaritan [376] | $363 | 200% |
| Meritain Health [300] | $365 | 201% |
| Health Net [340] | $394 | 217% |
| Administrative Concepts Inc [402] | $411 | 227% |
| First Health [339] | $411 | 227% |
| Manhattan Life Insurance Company [379] | $411 | 227% |
| Philadelphia American Life Insurance Company [395] | $411 | 227% |
| Planned Administrators Inc [375] | $411 | 227% |
| Auto Allstate Insurance [602] | $419 | 231% |
| Auto American Family Insurance [603] | $419 | 231% |
| Auto Country Insurance Claims [604] | $419 | 231% |
| Auto Dairyland Insurance [617] | $419 | 231% |
| Auto Farmers [605] | $419 | 231% |
| Auto Geico Claims Oregon [606] | $419 | 231% |
| Auto Hartford [612] | $419 | 231% |
| Auto Liberty Mutual Auto Ins [613] | $419 | 231% |
| Auto Mutual Of Enumclaw [610] | $419 | 231% |
| Auto Nationwide Allied Insuranc [601] | $419 | 231% |
| Auto Oregon Mutual [614] | $419 | 231% |
| Auto Progressive [608] | $419 | 231% |
| Auto Safeco Concentra [600] | $419 | 231% |
| Auto State Farm Claims [609] | $419 | 231% |
| Auto Sublimity Insurance [616] | $419 | 231% |
| Auto Travelers Insurance [615] | $419 | 231% |
| Auto Usaa [611] | $419 | 231% |
| Generic Auto [649] | $419 | 231% |
| Generic Workers Comp [699] | $419 | 231% |
| Otj Broadspire Services [670] | $419 | 231% |
| Otj Ccmsi [618] | $419 | 231% |
| Otj Chartis Claims [650] | $419 | 231% |
| Otj City County Ins Services [662] | $419 | 231% |
| Otj Corvel [676] | $419 | 231% |
| Otj Esis West Wc Claims [653] | $419 | 231% |
| Otj Gallagher Bassett [654] | $419 | 231% |
| Otj Hartford [655] | $419 | 231% |
| Otj Intermountain Claims Inc [666] | $419 | 231% |
| Otj Liberty Mutual Wausau Underwriters [671] | $419 | 231% |
| Otj Penser No American [663] | $419 | 231% |
| Otj Pinnacle Risk Mgmt [661] | $419 | 231% |
| Otj Saif [667] | $419 | 231% |
| Otj Sedgwick Cms [660] | $419 | 231% |
| Otj Sedgwick [668] | $419 | 231% |
| Otj Travelers Insurance [672] | $419 | 231% |
| Otj Tristar [673] | $419 | 231% |
| Bridgespan [342] | $443 | 244% |
| Asuris Northwest Health [202] | $522 | 288% |
| Healthcare Management Admin [201] | $522 | 288% |
| Regence Group Administrators [203] | $522 | 288% |