CMS Price Transparency Data

Family therapy session

Facility: Valley Children's Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $277
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.53x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Valley Children's Hospital is $277. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.53x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$277

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%)

Insurance Median: $277 (153%)

Ins. Median: $277 (153% 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
Allcare Ipa	$90	50%
Community Care Ipa	$90 - $142	50%
Dignity Ipa_Formerly Img	$126	69%
La Salle Ipa	$126	69%
Sante Ipa	$126	69%
Kaiser	$130 - $350	72%
Central Valley Medical Providers Ipa	$134 - $269	74%
Sequoia Health Ipa	$134	74%
Univseral Healthcare Ipa	$134	74%
United Physicians Network Ipa	$139	77%
Adventist	$158	87%
Blue Cross Blue Shield	$162 - $305	89%
Cencal Health	$177	98%
Kern Family Health Care	$179	99%
Health Net	$189 - $352	104%
Blue Shield	$259	143%
Dignity Health Central Coast	$267	147%
Community Care Health Plan	$277	153%
Community Health	$296	163%
Stanislaus Partners In Health	$296	163%
Physicians Choice Medical Group	$301	166%
Health Plan Of San Joaquin	$323	178%
Fowler Packing	$334	184%
Dignity (Formerly Managed Care Systems)	$339	187%
Kern Legacy	$350	193%
Aetna	$360	199%
UnitedHealthcare	$360 - $383	199%
First Health Formerly Coventry	$398	219%
Bakersfield Family Medical Group	$404	223%
Network By Design	$417	230%
Health Smart	$430	237%
Key Medical Ipa	$430	237%
Sutter Health	$457	252%
Multiplan	$515	284%

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 $X.
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 Valley Children's Hospital 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.