CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: UPMC Presbyterian Shadyside

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90834
  • Insurance Median: $284
  • Cash Discount Price: $235
  • vs. Medicare Baseline: 1.57x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at UPMC Presbyterian Shadyside is $284. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $235. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.57x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.
Cash / Self-Pay
$235

Average discount available for prompt cash payment at this facility.

Insurance Median
$284

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: $235 (130%)
Insurance Median: $284 (157%)
Cash: $235 (130% of Medicare)
Ins. Median: $284 (157% 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.

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
Upmc Health Plan $43 - $184 24%
UnitedHealthcare $47 26%
Aetna $51 - $168 28%
Highmark Wholecare (Prev Gateway) $58 - $196 32%
Health Partners Plans (Jefferson Health Plan) $59 33%
Geisinger $61 34%
Amerihealth Caritas $62 - $165 34%
Pa Health & Wellness $66 - $165 36%
Upmc Work Partners $120 66%
Multiplan $139 - $314 77%
Cigna $165 91%
Blue Cross Blue Shield $177 - $1,177 98%
Preferred Healthcare System $255 141%
Coventry/First Health $274 151%
Fidelis $294 162%
Intergroup $294 - $333 162%
Health Coalition Partners $314 173%
Private Health Care Systems $314 173%
Selectcare $314 173%
Health Payors Organization $333 184%
Humana $333 184%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Lothrop Street, Pittsburgh, PA 15213
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals