CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Marshfield Medical Center

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $200
Cash Discount Price: $213
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Marshfield Medical Center is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $213. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.10x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$213

Average discount available for prompt cash payment at this facility.

Insurance Median

$200

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: $213 (117%)

Insurance Median: $200 (110%)

Cash: $213 (117% of Medicare)

Ins. Median: $200 (110% 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
Family Health Center (Fhc)	$112	62%
Security Health Plan (Shp)	$114 - $167	63%
Amish/Mennonite	$123	68%
Sanford Health Plan	$123	68%
Veteran'S Administration (Va Ccn)	$153	84%
The Alliance	$156 - $187	86%
Blue Cross Blue Shield	$157 - $197	87%
Group Health Cooperative Of Eau Claire	$162 - $206	89%
Besse Forest Products	$190	105%
Molina Healthcare Of Wi	$190	105%
Rice Lake School District	$190	105%
Wps Health Insurance	$198 - $216	109%
Trilogy	$202 - $215	111%
UnitedHealthcare	$204	112%
Medica Of Wi	$208 - $212	115%
Cigna	$211	116%
Healtheos By Multiplan Inc.	$211 - $213	116%
Corvel	$213	117%
First Health	$213	117%
Health Partners	$213	117%
Three Rivers Provider Network (Trpn)	$213	117%
Coventry	$215	119%
Health Smart	$215	119%
Rising Medical Work Comp	$217	120%

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 $213.
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 Marshfield 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.