CMS Price Transparency Data

Family therapy session

Facility: Adventist Health Vallejo

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $558
Cash Discount Price: $156
vs. Medicare Baseline: 3.08x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Adventist Health Vallejo is $558. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 3.08x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.

Cash / Self-Pay

$156

Average discount available for prompt cash payment at this facility.

Insurance Median

$558

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: $156 (86%)

Insurance Median: $558 (308%)

Cash: $156 (86% of Medicare)

Ins. Median: $558 (308% 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 308% of the Medicare baseline (a markup of 208%). 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
Medi-Cal	$129	71%
Va Medi-Cal	$129	71%
Blue Shield Mcr Adv	$161	89%
Medicare (plans)	$161	89%
Napa County Mcal Child	$161	89%
Tricare	$161	89%
Va Mcr-All Other Plans	$161	89%
Ah Employee Health Plan-All Plans	$289	159%
Blue Shield Behav Hlth	$469	259%
Blue Shield Non-Epn-All Other Plans	$484	267%
Blue Shield Epn	$491	271%
Aetna	$542	299%
Phcs-All Plans	$574	317%
Western Growers-All Plans	$605	334%
Healthnet-All Plans	$639	352%
Interplan-All Plans	$678	374%
Choicecare-All Plans	$730	403%
Blue Cross Blue Shield	$768	424%
Beech Street-All Plans	$782	431%
Cigna	$834	460%
Kaiser-All Plans	$876	483%
Health Management Network-All Plans	$887	489%
Galaxy Network-All Plans	$939	518%
Three Rivers-All Plans	$939	518%

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 $156.
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 Vallejo 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.