CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Unitypoint Health - Meriter

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $183
Cash Discount Price: $417
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Unitypoint Health - Meriter is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $417. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.01x the Medicare baseline. Located in 202 S Park St, Madison, WI.

Cash / Self-Pay

$417

Average discount available for prompt cash payment at this facility.

Insurance Median

$183

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: $417 (230%)

Insurance Median: $183 (101%)

Cash: $417 (230% of Medicare)

Ins. Median: $183 (101% 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
Aspirus	$69 - $330	38%
Cigna	$84 - $173	46%
Security Health Plan	$90 - $185	50%
Mercy Care	$105 - $216	58%
Blue Cross Blue Shield	$132 - $586	73%
Illinicare	$132 - $155	73%
Prevea 360	$132 - $524	73%
UnitedHealthcare	$132 - $284	73%
Humana	$139 - $155	77%
Meridiancare	$139 - $155	77%
Quartz	$172	95%
Health Partners Open Network	$193 - $201	106%
Medical Associates Health Plan	$198 - $567	109%
Wellmark Uph Self-Funded	$317 - $394	175%

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 $417.
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 Unitypoint Health - Meriter 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.