CMS Price Transparency Data

Family therapy session

Facility: Pocahontas Community Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $909
Cash Discount Price: $952
vs. Medicare Baseline: 5.01x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Pocahontas Community Hospital is $909. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $952. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 5.01x the Medicare baseline. Located in 606 N W 7Th Street, Pocahontas, IA.

Cash / Self-Pay

$952

Average discount available for prompt cash payment at this facility.

Insurance Median

$909

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: $952 (525%)

Insurance Median: $909 (501%)

Cash: $952 (525% of Medicare)

Ins. Median: $909 (501% 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 501% of the Medicare baseline (a markup of 401%). 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
Molina	$476 - $952	262%
Wellpoint	$514 - $952	283%
Iowa Total Care	$530 - $952	292%
Aetna	$571 - $952	315%
Blue Cross Blue Shield	$609 - $952	336%
Health Partners	$899 - $904	496%
Humana	$904 - $952	499%
UnitedHealthcare	$914	504%
Cigna	$923	509%
Great West	$923	509%

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 $952.
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 Pocahontas Community 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.