CMS Price Transparency Data

Family therapy session

Facility: Medstar Health Physical Therapy

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $430
Cash Discount Price: $430
vs. Medicare Baseline: 2.37x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Medstar Health Physical Therapy is $430. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $430. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.37x the Medicare baseline. Located in 102 Irving St Nw, Washington, DC.

Cash / Self-Pay

$430

Average discount available for prompt cash payment at this facility.

Insurance Median

$430

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: $430 (237%)

Insurance Median: $430 (237%)

Cash: $430 (237% of Medicare)

Ins. Median: $430 (237% 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 237% of the Medicare baseline (a markup of 137%). 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
Carefirst Advantage Inc	$186	103%
Tricare	$189	104%
UnitedHealthcare	$189 - $450	104%
Aetna	$192 - $463	106%
Health Care Service Corporation	$195	108%
Humana	$195	108%
Kaiser Permanente	$195 - $463	108%
Carefirst Blue Choice Inc	$324 - $423	179%
Jhhc	$430	237%
Pfc	$430	237%
Medstar Family Choice Inc	$469	259%
Kaiser	$517	285%
Cigna	$562	310%
First Health	$562	310%
Private Healthcare Systems (Phcs)	$562	310%

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 $430.
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 Medstar Health Physical Therapy 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.