CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Sweeny Community Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $187
Cash Discount Price: $173
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Sweeny Community Hospital is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $173. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.03x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.

Cash / Self-Pay

$173

Average discount available for prompt cash payment at this facility.

Insurance Median

$187

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: $173 (95%)

Insurance Median: $187 (103%)

Cash: $173 (95% of Medicare)

Ins. Median: $187 (103% 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	$87 - $144	48%
Evercare Mcaid	$144	79%
Aetna	$167 - $231	92%
Amerigroup Mcr Adv - All Other Plans	$167	92%
Community Hlth Choice Him - All Other Plans	$167	92%
Coventry Mcr Adv	$167	92%
Molina Mcr Adv - All Other Plans	$167	92%
Superior Hp Mcr Adv-All Other Plans	$167	92%
Wellcare Mcare - All Plans	$167	92%
Care Improvement Mcr - All Plans	$169	93%
Choicecare Mcr Adv - All Plans	$169	93%
Cigna	$187	103%
Community Hlth Choice Star	$204	112%
Molina Mcaid	$204	112%
Superior Hp Mcaid	$204	112%
Tx Chlidrens Hp Mcaid - All Plans	$204	112%
Tx True Choice Mcaid - All Plans	$204	112%
Beech Street - All Plans	$216	119%
Community Care Network - All Plans	$231	127%
UnitedHealthcare	$231	127%
Galaxy Health Network - All Plans	$260	143%
Multiplan - All Plans	$260	143%
Evercare Mcr Adv - All Other Plans	$280	154%
Amerigroup Mcaid	$288	159%

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 $173.
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 Sweeny Community 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.