CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: UPMC Pinnacle Hospitals

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $255
Cash Discount Price: $302
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at UPMC Pinnacle Hospitals is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $302. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.41x the Medicare baseline. Located in 409 South Second Street, Harrisburg, PA.

Cash / Self-Pay

$302

Average discount available for prompt cash payment at this facility.

Insurance Median

$255

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: $302 (167%)

Insurance Median: $255 (141%)

Cash: $302 (167% of Medicare)

Ins. Median: $255 (141% 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
Amerihealth Caritas	$66	36%
UnitedHealthcare	$68	37%
Health Partners Plans (Jefferson Health Plan)	$71	39%
Geisinger	$76	42%
Pa Health & Wellness	$89 - $171	49%
Blue Cross Blue Shield	$101 - $1,604	56%
Keystone Health Plan	$101 - $292	56%
Prime Net	$122 - $379	67%
Humana	$163	90%
Aetna	$165 - $309	91%
Cigna	$166	92%
Upmc Work Partners	$175	97%
Intergroup	$328 - $428	181%
Upmc Health Plan	$353	195%
Wellspan Population Health	$428	236%

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 $302.
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 UPMC Pinnacle Hospitals 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.