CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Aurora Medical Center Sheboygan County

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $296
  • Cash Discount Price: $228
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Aurora Medical Center Sheboygan County is $296. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.63x the Medicare baseline. Located in 2629 N 7Th St, Sheboygan, WI.
Cash / Self-Pay
$228

Average discount available for prompt cash payment at this facility.

Insurance Median
$296

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: $228 (126%)
Insurance Median: $296 (163%)
Cash: $228 (126% of Medicare)
Ins. Median: $296 (163% 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 $228 126%
Hs Technology $228 126%
Aetna $243 - $376 134%
Quartz One $250 138%
UnitedHealthcare $270 - $383 149%
Aurora Caregiver $273 151%
Blue Cross Blue Shield $273 - $387 151%
Common Ground $273 151%
Health Eos Plus $273 151%
Healthpartners $273 - $341 151%
Molina Exchange $273 151%
Quartz Group $273 151%
Wisconsin Physician Service $282 - $296 156%
Health Payment Systems $296 163%
Trilogy $318 175%
Centivo $341 188%
Cigna $341 - $385 188%
Health Eos $364 201%

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