CMS Price Transparency Data

Family therapy session

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $139
Cash Discount Price: $441
vs. Medicare Baseline: 0.77x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Cleveland Clinic Indian River Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.77x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.

Cash / Self-Pay

$441

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $441 (243%)

Insurance Median: $139 (77%)

Cash: $441 (243% of Medicare)

Ins. Median: $139 (77% 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
UnitedHealthcare	$77	42%
Amerihealth	$81	45%
Medicaid / KanCare	$81	45%
Molina	$81	45%
Value Options	$81 - $104	45%
Wellcare	$81 - $161	45%
Blue Cross Blue Shield	$85 - $161	47%
Magellan	$85 - $247	47%
Cigna	$100 - $137	55%
Avmed	$104 - $369	57%
Careplus	$104 - $161	57%
United	$104 - $161	57%
Freedom Health	$109 - $161	60%
Independent Living Systems	$109 - $169	60%
Wellmed	$109 - $161	60%
Clear Spring Health	$112 - $159	62%
Aetna	$121 - $850	67%
Carelon Bh Strategies	$161	89%
Humana	$161	89%
Devoted Health	$177	98%
Bmi	$227	125%
Clarity Health	$268 - $614	148%
The Legacy Companies	$268 - $614	148%
Multiplan	$330	182%
National Provider Network	$661	365%
Three Rivers	$661	365%
Consociate Health	$708	390%

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 $441.
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 Cleveland Clinic Indian River 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.