CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Punxsutawney Area Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $172
Cash Discount Price: $159
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Punxsutawney Area Hospital is $172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.95x the Medicare baseline. Located in 81 Hillcrest Drive, Punxsutawney, PA.

Cash / Self-Pay

$159

Average discount available for prompt cash payment at this facility.

Insurance Median

$172

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: $159 (88%)

Insurance Median: $172 (95%)

Cash: $159 (88% of Medicare)

Ins. Median: $172 (95% 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
UnitedHealthcare	$57 - $191	31%
Highmark Wholecare	$98 - $172	54%
Upmc Health Plan	$109 - $238	60%
Highmark	$115 - $1,030	63%
Tricare	$136 - $168	75%
Ambetter / Centene	$144 - $195	79%
Aetna	$161 - $407	89%
Amerihealth Caritas	$161 - $182	89%
Geisinger Health Plan	$164 - $186	90%
United Mine Workers Of America	$164 - $185	90%
Humana	$182	100%
Pa Health And Wellness Commercial	$205 - $370	113%
Cigna	$213 - $283	117%
Geisinger	$229 - $518	126%
Pa Workers Compensation	$359 - $477	198%

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 $159.
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 Punxsutawney Area 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.