CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Aurora Medical Center Sheboygan County

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90834
  • Insurance Median: $218
  • Cash Discount Price: $168
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Aurora Medical Center Sheboygan County is $218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.20x the Medicare baseline. Located in 2629 N 7Th St, Sheboygan, WI.
Cash / Self-Pay
$168

Average discount available for prompt cash payment at this facility.

Insurance Median
$218

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: $168 (93%)
Insurance Median: $218 (120%)
Cash: $168 (93% of Medicare)
Ins. Median: $218 (120% 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
Everpointe Elite $168 93%
Hs Technology $168 93%
Aetna $179 - $277 99%
Quartz One $184 101%
UnitedHealthcare $199 - $282 110%
Aurora Caregiver $201 111%
Blue Cross Blue Shield $201 - $285 111%
Common Ground $201 111%
Health Eos Plus $201 111%
Healthpartners $201 - $251 111%
Molina Exchange $201 111%
Quartz Group $201 111%
Wisconsin Physician Service $208 - $218 115%
Health Payment Systems $218 120%
Trilogy $234 129%
Centivo $251 138%
Cigna $251 - $283 138%
Health Eos $268 148%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2629 N 7Th St, Sheboygan, WI 53083
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals