CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: UPMC Presbyterian Shadyside

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $307
Cash Discount Price: $254
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at UPMC Presbyterian Shadyside is $307. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.69x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.

Cash / Self-Pay

$254

Average discount available for prompt cash payment at this facility.

Insurance Median

$307

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: $254 (140%)

Insurance Median: $307 (169%)

Cash: $254 (140% of Medicare)

Ins. Median: $307 (169% 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
Upmc Health Plan	$57 - $199	31%
UnitedHealthcare	$62	34%
Aetna	$68 - $168	37%
Highmark Wholecare (Prev Gateway)	$77 - $212	42%
Health Partners Plans (Jefferson Health Plan)	$78	43%
Geisinger	$81	45%
Amerihealth Caritas	$82 - $165	45%
Pa Health & Wellness	$89 - $165	49%
Cigna	$165	91%
Upmc Work Partners	$175	97%
Multiplan	$204 - $339	112%
Blue Cross Blue Shield	$259 - $1,719	143%
Preferred Healthcare System	$276	152%
Coventry/First Health	$297	164%
Fidelis	$318	175%
Intergroup	$318 - $360	175%
Health Coalition Partners	$339	187%
Private Health Care Systems	$339	187%
Selectcare	$339	187%
Health Payors Organization	$360	199%
Humana	$360	199%

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 $254.
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 Presbyterian Shadyside 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.