CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Margaretville Memorial Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $205
Cash Discount Price: $423
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Margaretville Memorial Hospital is $205. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $423. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.13x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$423

Average discount available for prompt cash payment at this facility.

Insurance Median

$205

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: $423 (233%)

Insurance Median: $205 (113%)

Cash: $423 (233% of Medicare)

Ins. Median: $205 (113% 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
Blue Cross Blue Shield	$141 - $188	78%
Mvp Gold (McR)	$186	103%
Medicare (plans)	$186 - $279	103%
Aetna	$186 - $275	103%
UnitedHealthcare	$186 - $384	103%
Hamaspik (McR)	$186	103%
Affinity By Molina McR	$195	108%
Cdphp	$205	113%
Self-Pay	$262	144%
Mvp Exchange	$275	152%
Emblem Select Care (Exchange)	$288	159%
Oxford Exchange	$296	163%
Magnacare Standard	$296	163%
Emblem Ghi/Hip Ppo/Cbp	$305	168%
Todays Options	$307	169%
Emblem Ghi/Hip Hmo/Epo/Pos	$338	186%
Multiplan	$347	191%
Mvp	$377	208%
First Health	$381	210%
Mvp Hmo/Ppo	$1,245	687%

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 $423.
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 Margaretville 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.