CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Adventist Health Tillamook

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $150
Cash Discount Price: $123
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Adventist Health Tillamook is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.83x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$150

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: $123 (68%)

Insurance Median: $150 (83%)

Cash: $123 (68% of Medicare)

Ins. Median: $150 (83% 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
Pacificsource - All Plans	$48 - $149	26%
Blue Cross Blue Shield	$73 - $332	40%
Medicare (plans)	$73 - $142	40%
Moda Health Plan - All Plans	$73 - $138	40%
Hvhs Mcare - All Plans	$74 - $163	41%
Sterling Life - All Plans	$76 - $140	42%
Devoted Health	$79 - $146	44%
Aetna	$81 - $212	45%
Lifewise - All Plans	$140 - $345	77%
Ah Employee Health Plan - All Plans	$146 - $359	81%
First Choice Health- All Plans	$146 - $359	81%
Health Net - All Plans	$146 - $359	81%
Cigna	$147	81%
Phcs Preferred - All Plans	$147	81%
UnitedHealthcare	$147 - $286	81%
Ods Health Plan - All Other Plans	$150 - $265	83%
Providence Preferred - All Plans	$152 - $374	84%
Workers Comp	$155 - $382	85%

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 $123.
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 Adventist Health Tillamook 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.