CMS Price Transparency Data

Family therapy session

Facility: St Anthony Regional Hospital & Nursing Home

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $102
Cash Discount Price: $107
vs. Medicare Baseline: 0.56x Medicare

The contracted insurance negotiated median rate for a Family therapy session at St Anthony Regional Hospital & Nursing Home is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.56x the Medicare baseline. Located in 311 South Clark Street, Carroll, IA.

Cash / Self-Pay

$107

Average discount available for prompt cash payment at this facility.

Insurance Median

$102

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: $107 (59%)

Insurance Median: $102 (56%)

Cash: $107 (59% of Medicare)

Ins. Median: $102 (56% 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
Aetna	$24 - $158	13%
Humana	$24 - $188	13%
Ia Total Care Mcr	$24 - $105	13%
Medica Mcr - All Plans	$24 - $102	13%
UnitedHealthcare	$24 - $163	13%
Va Ccn - All Plans	$24 - $102	13%
Wellpoint Mcr Adv	$24 - $102	13%
Ia Total Care Mcaid	$27 - $221	15%
Wellpoint Mcaid - All Other Plans	$27 - $221	15%
Molina Mcaid - All Plans	$28 - $225	15%
Ia Total Care Comm - All Other Plans	$31 - $132	17%
Midlands Choice - All Plans	$62 - $115	34%
Wellmark Hmo	$81 - $149	45%
Wellmark Ppo-All Other Plans	$89 - $149	49%

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 $107.
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 St Anthony Regional Hospital & Nursing Home 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.