CMS Price Transparency Data

Family therapy session

Facility: Boone County Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $384
Cash Discount Price: $676
vs. Medicare Baseline: 2.12x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Boone County Hospital is $384. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $676. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.12x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$676

Average discount available for prompt cash payment at this facility.

Insurance Median

$384

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: $676 (373%)

Insurance Median: $384 (212%)

Cash: $676 (373% of Medicare)

Ins. Median: $384 (212% 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 212% of the Medicare baseline (a markup of 112%). 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
Wellmark Hmo	$136	75%
Wellmark Ppo - All Other Plans	$150	83%
Tricare	$181	100%
Choice Care Mcr Adv - All Plans	$346	191%
Humana	$346 - $760	191%
Iowa Hlth Adv - All Plans	$346	191%
Mt Carmel Hp - All Plans	$346	191%
Amerigroup Mcr Adv - All Other Plans	$350	193%
Aetna	$354 - $659	195%
Meridian Mcaid - All Plans	$380	210%
Iowa Total Care Mcaid - All Plans	$388	214%
Medicaid / KanCare	$392	216%
Healthsmart Accell Network	$592	326%
Medical Associates Hp-All Plans	$634	350%
Healthsmart Ppo - All Other Plans	$676	373%
Health Alliance-All Plans	$760	419%
Midlands Choice-All Plans	$777	428%
Mutually Preferred-All Plans	$803	443%

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 $676.
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 Boone County 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.