CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Community Memorial Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $156
Cash Discount Price: $112
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Community Memorial Hospital is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.86x the Medicare baseline. Located in W180 N8085 Town Hall Rd, Menomonee Falls, WI.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$156

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: $112 (62%)

Insurance Median: $156 (86%)

Cash: $112 (62% of Medicare)

Ins. Median: $156 (86% 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
Centivo	$61 - $67	34%
UnitedHealthcare	$67 - $156	37%
Froedtert South	$86	47%
Chorus Community Health Plan	$88	49%
Network Health Plan	$112 - $156	62%
Common Ground	$122	67%
Sheboygan Employers Health Network	$126	69%
Compsych	$128	71%
Health Partners	$133 - $156	73%
Blue Cross Blue Shield	$135 - $173	74%
Trilogy	$141	78%
Health Payment Systems	$142	78%
Aetna	$143 - $159	79%
Wisconsin Physician Services	$143	79%
Allwell	$156	86%
Community Care	$156	86%
Humana	$156	86%
Icare	$156	86%
Security Health Plan	$156	86%
Care Wisconsin/Mychoice	$161	89%
Aspirus	$163	90%
Ibsi Passport	$165	91%
Americas Choice	$177	98%
Federated Mutual	$177	98%
Healtheos	$177	98%
Multiplan/Private Healthcare Systems	$177	98%
Savility	$177	98%
Cigna	$180	99%
First Health Network	$180	99%
Healthsmart	$184	101%
Physicians Plus	$184	101%

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 $112.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90834.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Community Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90834.
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.