CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: St Joseph's Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $269
  • Cash Discount Price: $228
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at St Joseph's Hospital is $269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.48x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$228

Average discount available for prompt cash payment at this facility.

Insurance Median
$269

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: $228 (126%)
Insurance Median: $269 (148%)
Cash: $228 (126% of Medicare)
Ins. Median: $269 (148% 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.

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
UnitedHealthcare $63 - $316 35%
Blue Cross Blue Shield $63 35%
Clear Spring Health of Illinois $63 35%
Molina Healthcare $63 - $312 35%
Humana $63 35%
Sae Hospice $63 35%
Aetna $63 - $221 35%
Amish Community $88 49%
Naphcare $133 73%
Celtic Insurance Company $139 77%
Claim Doc $158 87%
Hopetrust $158 87%
Wellfirst $202 111%
Cigna $212 117%
First Health $234 129%
Healthlink $269 148%
Multiplan/Phcs $269 148%
Provider Network of America $284 157%
Healthcare Finest Network (Hfn) $284 157%
Mental Health Network $316 174%
Current Health Solutions $316 174%
Qtc Medical Group of Illinois $316 174%
Interplan $316 174%
Illinois Breast and Cervical Cancer Program $316 174%
Health Alliance Medical Plans $316 174%
Consociate Group $316 174%
Healthscope $316 174%
Meridian Health Plan $327 180%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals