CMS Price Transparency Data

Family therapy session

Facility: Madison County Health Care System

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $293
Cash Discount Price: $360
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Madison County Health Care System is $293. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $360. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.62x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.

Cash / Self-Pay

$360

Average discount available for prompt cash payment at this facility.

Insurance Median

$293

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: $360 (199%)

Insurance Median: $293 (162%)

Cash: $360 (199% of Medicare)

Ins. Median: $293 (162% 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
Blue Cross Blue Shield	$81 - $89	45%
Aetna	$194 - $292	107%
Medical Associates Hp - All Plans	$194	107%
Medigold-All Plans	$194	107%
Tricare	$194	107%
American Hp Mcr Adv-All Plans	$203	112%
Iowa Total Care Mcaid-All Plans	$212	117%
UnitedHealthcare	$212	117%
Molina Mcaid/Chip -All Plans	$219	121%
Amerigroup Mcaid-All Plans	$224	124%
Madison County Sheriff-All Plans	$225	124%
Oscar - All Plans	$290	160%
Corvel Wc-All Plans	$405	223%
Choicecare-All Plans	$428	236%
First Choice-All Plans	$428	236%
First Health-All Plans	$428	236%
Integrated Hp-All Plans	$428	236%
Mutual Of Omaha-All Plans	$428	236%
Plaines Health-All Plans	$428	236%
Preferred Hlth Ntwork-All Plans	$428	236%
Principal Healthcare-All Plans	$428	236%
Usa Managed Care-All Plans	$428	236%
Medimore Employee Hp - All Plans	$441	243%
Midlands Choice - All Plans	$441	243%
Benefit Admin Of America-All Plans	$450	248%

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 $360.
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 Madison County Health Care System 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.