CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Sanford Usd Medical Center

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $198
Cash Discount Price: $290
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Sanford Usd Medical Center is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $290. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.09x the Medicare baseline. Located in 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD.

Cash / Self-Pay

$290

Average discount available for prompt cash payment at this facility.

Insurance Median

$198

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: $290 (160%)

Insurance Median: $198 (109%)

Cash: $290 (160% of Medicare)

Ins. Median: $198 (109% 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
Blue Cross Blue Shield	$71 - $201	39%
Health Partners	$122 - $165	67%
Sanford Health Plan	$133	73%
Sanford Health Plan Align	$153	84%
Ucare	$164 - $255	90%
Aetna	$165 - $278	91%
Medicare (plans)	$165	91%
UnitedHealthcare	$165 - $320	91%
Primewest	$167 - $169	92%
Security Health Plan	$200	110%
Medica	$245 - $262	135%
First Choice Health Network	$327	180%
Healthez	$327	180%
Multiplan	$327	180%

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 $290.
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 Sanford Usd Medical Center 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.