CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Vandalia Health Broaddus Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $705
Cash Discount Price: $574
vs. Medicare Baseline: 3.89x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Vandalia Health Broaddus Hospital is $705. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $574. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 3.89x the Medicare baseline. Located in 1 Healthcare Drive Mansfield Hill, Philippi, WV.

Cash / Self-Pay

$574

Average discount available for prompt cash payment at this facility.

Insurance Median

$705

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: $574 (317%)

Insurance Median: $705 (389%)

Cash: $574 (317% of Medicare)

Ins. Median: $705 (389% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 389% of the Medicare baseline (a markup of 289%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Correctional Medical Systems	$66	36%
Aetna	$70 - $733	39%
The Health Plan	$70 - $738	39%
Unicare	$70	39%
Blue Cross Blue Shield	$112 - $582	62%
Peak Health	$141 - $261	78%
Highmark	$601	331%
UnitedHealthcare	$607 - $796	335%
Humana	$631	348%
West Virginia Senior Advantage	$637	351%
Cigna	$718	396%
First Health	$733	404%
Geisenger Health Plan	$763	421%
Health Network America	$763 - $779	421%
Multiplan/Phcs	$771	425%
Geha	$779	430%
Selectnet	$804	443%

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 $574.
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 Vandalia Health Broaddus 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.