CMS Price Transparency Data

Family therapy session

Facility: Franklin General Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $223
Cash Discount Price: $474
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Franklin General Hospital is $223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $474. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.23x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$474

Average discount available for prompt cash payment at this facility.

Insurance Median

$223

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: $474 (261%)

Insurance Median: $223 (123%)

Cash: $474 (261% of Medicare)

Ins. Median: $223 (123% 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
Wellmark Hmo	$81	45%
Wellmark Ppo - All Other Plans	$89	49%
Medical Associates Mcare	$211	116%
Mount Carmel Hp-All Plans	$211	116%
Tricare	$211	116%
Amerigroup Mcare	$213	117%
Wellmark Mcr Adv	$213	117%
Molina Mcare	$219	121%
Ambetter / Centene	$220 - $337	121%
American Hp Iowa - All Plans	$221	122%
Amerigroup Mcaid - All Other Plans	$223	123%
Molina Mcaid - All Other Plans	$224	124%
Centivo - All Plans	$316	174%
Medical Ass Hosp Employer Group	$316	174%
Oscar - All Plans	$316	174%
Midlands Choice-All Plans	$369	203%
Medical Associates Hp-All Other Plans	$448	247%
Preferred Health Choices-All Plans	$448	247%
Splashlight Llc-All Plans	$448	247%
Aetna	$490 - $501	270%
Multiplan-All Plans	$501	276%

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 $474.
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 Franklin General 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.