CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: North Central Health Care

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $170
Cash Discount Price: $286
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at North Central Health Care is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $286. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.94x the Medicare baseline. Located in 1150 Lakeview Dr, Wausau, WI.

Cash / Self-Pay

$286

Average discount available for prompt cash payment at this facility.

Insurance Median

$170

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: $286 (158%)

Insurance Median: $170 (94%)

Cash: $286 (158% of Medicare)

Ins. Median: $170 (94% 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
Medicaid / KanCare	$109	60%
Inclusa - Family Care Wps Insurance	$132	73%
Blue Cross Blue Shield	$168 - $170	93%
Medicare (plans)	$168	93%
UnitedHealthcare	$168 - $170	93%
Advantage By Managed	$170	94%
Aetna	$170	94%
Aither Health Plan	$170	94%
Allied Benefits	$170	94%
Aspirus Health Plan - First Health Network	$170	94%
Auxiant	$170	94%
Dean Care	$170	94%
Health Eos - Multiplan	$170	94%
Humana	$170	94%
I - Care	$170	94%
Iris	$170	94%
Lakeland Care District/Wps Insurance	$170	94%
Medica Claims	$170	94%
Molina	$170	94%
Molina Insurance	$170	94%
Security Administrative Services	$170	94%
Surest	$170	94%
The Alliance	$170	94%
United Behavioral Health	$170	94%
Group Health Cooperative	$179	99%
Cenpatico	$183	101%
Security Health Plan	$187	103%
Security Health Plan - HMO	$187	103%

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 $286.
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 North Central Health Care 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.