CMS Price Transparency Data

Family therapy session

Facility: Adventist Health Lodi Memorial

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $152
Cash Discount Price: $18
vs. Medicare Baseline: 0.84x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Adventist Health Lodi Memorial is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.84x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.

Cash / Self-Pay

$18

Average discount available for prompt cash payment at this facility.

Insurance Median

$152

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: $18 (10%)

Insurance Median: $152 (84%)

Cash: $18 (10% of Medicare)

Ins. Median: $152 (84% 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
Medcore(Omni Ipa) Op Only- All Plans	$68	37%
Blue Shield Epn - All Other Plans	$85	47%
Blue Shield Non-Epn	$88	49%
Aetna	$106	58%
Kaiser Commercial - All Other Plans	$107	59%
Bc Mcal	$123	68%
Healthnet- All Other Plans	$128	71%
Kaiser Mcal	$129	71%
Medi-Cal	$129	71%
Networks By Design- All Plans	$130	72%
Celtic Ins Company - All Plans	$144	79%
Alignment Health Plan (Ahp)-All Plans	$152	84%
Blue Shield Mcare Adv	$152	84%
Healthnet Mcare	$152	84%
Hp Of San Joaquin Mcr Adv	$152	84%
Humana	$152	84%
Kaiser Mcr Adv	$152	84%
Tricare	$152	84%
UnitedHealthcare	$152	84%
Cca Health Plan Mcr Adv- All Plans	$155	85%
Hp Of San Joaquin Mcal	$161	89%
Blue Cross Blue Shield	$168 - $187	93%
Knnex Health - All Plans	$182	100%
Healthnet Mcal	$184	101%
Multiplan- All Plans	$209	115%
First Health- All Plans	$214	118%
Beech Street- All Plans	$235	130%
Cigna	$235	130%
Three Rivers Provider Network- All Plans	$235	130%
Western Growers- All Plans	$235	130%
Hp Of San Joaquin Ppo - All Other Plans	$248	137%
Ah Employee Health Plan - All Plans	$274	151%
Bright Health - All Plans	$304	168%

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 $18.
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 Lodi Memorial 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.