CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: North Central Health Care

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $253
Cash Discount Price: $424
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at North Central Health Care is $253. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $424. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.40x the Medicare baseline. Located in 1150 Lakeview Dr, Wausau, WI.

Cash / Self-Pay

$424

Average discount available for prompt cash payment at this facility.

Insurance Median

$253

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: $424 (234%)

Insurance Median: $253 (140%)

Cash: $424 (234% of Medicare)

Ins. Median: $253 (140% 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	$162	89%
Inclusa - Family Care Wps Insurance	$195	108%
Blue Cross Blue Shield	$249 - $253	137%
Medicare (plans)	$249	137%
UnitedHealthcare	$249 - $253	137%
Advantage By Managed	$253	140%
Aetna	$253	140%
All Savers	$253	140%
Aspirus Health Plan - First Health Network	$253	140%
Cigna	$253	140%
Dean Care	$253	140%
Health Eos - Multiplan	$253	140%
Humana	$253	140%
I - Care	$253	140%
Lakeland Care District/Wps Insurance	$253	140%
Molina	$253	140%
The Alliance	$253	140%
United Behavioral Health	$253	140%
Group Health Cooperative	$265	146%
Cenpatico	$271	149%
Security Health Plan	$277	153%
Security Health Plan - HMO	$277	153%

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 $424.
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 North Central Health Care 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.