CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Cook Childrens Medical Center Prosper

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $398
Cash Discount Price: $615
vs. Medicare Baseline: 2.19x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Cook Childrens Medical Center Prosper is $398. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $615. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.19x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$615

Average discount available for prompt cash payment at this facility.

Insurance Median

$398

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: $615 (339%)

Insurance Median: $398 (219%)

Cash: $615 (339% of Medicare)

Ins. Median: $398 (219% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 219% of the Medicare baseline (a markup of 119%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Health Plan W. Uhrip	$114	63%
Health Plan W/O Uhrip	$114 - $489	63%
Aetna	$163 - $769	90%
Superior Health	$244 - $301	135%
Wellpoint	$256 - $316	141%
Blue Cross Blue Shield	$263 - $815	145%
United Community	$271 - $397	149%
UnitedHealthcare	$323 - $769	178%
Beacon	$338 - $489	186%
El Paso Health First	$338 - $489	186%
Tx Children Health	$338 - $489	186%
Firstcare	$354 - $724	195%
S&W Health	$616 - $760	340%
Cigna	$624 - $769	344%
Healthscope	$624 - $769	344%
Imagine Health	$624 - $769	344%
Humana	$638 - $796	352%
Multiplan	$638 - $787	352%
First Health	$646 - $796	356%
Galaxy Health	$660 - $815	364%
Healthsmart	$660 - $815	364%
Usamco	$675 - $833	372%

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 $615.
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 Cook Childrens Medical Center Prosper 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.