CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: West Penn Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $131
Cash Discount Price: $107
vs. Medicare Baseline: 0.72x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at West Penn Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.72x the Medicare baseline. Located in 4800 Friendship Avenue, Pittsburgh, PA.

Cash / Self-Pay

$107

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $107 (59%)

Insurance Median: $131 (72%)

Cash: $107 (59% of Medicare)

Ins. Median: $131 (72% 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
Carelon	$81 - $157	45%
UnitedHealthcare	$83 - $542	46%
Community Care Behavorial Health Healthchoices	$98 - $130	54%
Community Care Behavorial Health University Of Pittsburgh Medical Center	$98 - $130	54%
Highmark	$110 - $392	61%
Life Pittsburgh	$132 - $155	73%
Medicare (plans)	$140 - $159	77%
American Health Plans	$145 - $155	80%
Martin'S Point	$155	85%
Aetna	$161 - $512	89%
Amerihealth	$162	89%
Highmark Wholecare	$164	90%
Humana	$164	90%
Cigna	$165 - $513	91%
Molina	$168	93%
Medical Mutual	$513	283%

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 $107.
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 West Penn Hospital 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.