CMS Price Transparency Data

Family therapy session

Facility: Adventist Health St Helena

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $732
Cash Discount Price: $189
vs. Medicare Baseline: 4.04x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Adventist Health St Helena is $732. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $189. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 4.04x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$189

Average discount available for prompt cash payment at this facility.

Insurance Median

$732

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: $189 (104%)

Insurance Median: $732 (404%)

Cash: $189 (104% of Medicare)

Ins. Median: $732 (404% 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 404% of the Medicare baseline (a markup of 304%). 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
Va Medi-Cal	$129	71%
Blue Shield Bh Mcr Adv	$236	130%
Blue Shield Mcr Adv	$236	130%
Kaiser Mcr Adv	$236	130%
Tricare	$236	130%
Va Mcr - All Other Plans	$236	130%
Ah Employee Health Plan - All Plans	$424	234%
Blue Shield Behav Hlth	$568	313%
Blue Shield Non-Epn	$586	323%
Blue Shield Epn-All Other Plans	$594	328%
Aetna	$656	362%
Phcs-All Plans	$694	383%
Western Growers-All Plans	$732	404%
Healthnet-All Plans	$774	427%
Interplan-All Plans	$820	452%
Blue Cross Blue Shield	$836 - $929	461%
Choicecare-All Plans	$883	487%
Beech Street-All Plans	$946	522%
Cigna	$1,010	557%
Kaiser-All Other Plans	$1,035	571%
Health Management Network-All Plans	$1,073	592%
Galaxy Network-All Plans	$1,136	626%
Three Rivers-All Plans	$1,136	626%

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 $189.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90847.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health St Helena is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90847.
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.