CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Prisma Health Tuomey Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90834
  • Insurance Median: $334
  • Cash Discount Price: $321
  • vs. Medicare Baseline: 1.84x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Prisma Health Tuomey Hospital is $334. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $321. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.84x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$321

Average discount available for prompt cash payment at this facility.

Insurance Median
$334

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: $321 (177%)
Insurance Median: $334 (184%)
Cash: $321 (177% of Medicare)
Ins. Median: $334 (184% 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
Medicaid / KanCare $61 - $87 34%
Humana $65 - $426 36%
UnitedHealthcare $65 - $364 36%
Tricare $87 48%
Prisma Health Seniorcare Pace - Midlands [5400] $97 - $132 53%
Prisma Health Seniorcare Pace-Upstate [5200] $97 - $132 53%
Blue Cross Blue Shield $147 - $613 81%
Bluechoice [810] $147 - $612 81%
Promise Health Plan Contracted [2401] $147 - $341 81%
Companion Benefit Alternatives [2983] $162 - $351 89%
Orangeburg Senior Helping Center Pace [5401] $168 - $227 93%
Carelon Behavioral Health [3180] $175 - $375 97%
Bob Jones Univ-Pai [821] $252 - $341 139%
Scdc-Sc Dept Of Corrections [7232] $255 - $464 141%
Aetna $269 - $449 148%
Golden Rule Insurance Company [2991] $269 - $364 148%
Meritain Health Contracted [2200] $269 - $449 148%
Oxford Health Plans [2992] $269 - $364 148%
Zzumr-Salt Lake City Ut [3169] $269 - $364 148%
Preferred Administrators Contracted [2839] $294 - $398 162%
Medcost [2940] $311 - $471 172%
Atlantic Packaging Contracted [4833] $315 - $426 174%
Cigna $322 - $436 178%
Aps Healthcare System [2981] $336 - $454 185%
Multiplan/Phcs Contracted [2950] $374 - $506 206%
Vsp Vision Care [2986] $378 - $511 208%
First Health Contracted [2952] $391 - $528 216%
Furman Int/Allen University Student [2951] $391 - $528 216%
Quiktrip-First Health [3067] $391 - $528 216%
Planned Administrators [820] $613 338%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals