CMS Price Transparency Data

Family therapy session

Facility: Pinckneyville Community Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $234
Cash Discount Price: $300
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Pinckneyville Community Hospital is $234. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $300. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.29x the Medicare baseline. Located in 5383 State Route 154, Pinckneyville, IL.

Cash / Self-Pay

$300

Average discount available for prompt cash payment at this facility.

Insurance Median

$234

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: $300 (165%)

Insurance Median: $234 (129%)

Cash: $300 (165% of Medicare)

Ins. Median: $234 (129% 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
Humana	$104 - $170	57%
Umwa Mcr Adv - All Plans	$104 - $170	57%
UnitedHealthcare	$104 - $376	57%
Wellcare Mcr Adv - All Plans	$104 - $170	57%
Aetna	$106 - $920	58%
Blue Cross Blue Shield	$203 - $920	112%
Healthlink Hmo	$221 - $360	122%
Phcs - All Other Plans	$231 - $376	127%
Cigna	$232 - $379	128%
Healthlink Ppo - All Other Plans	$232 - $379	128%
Healthlink Work Comp	$232 - $379	128%
Phcs Savility	$239 - $390	132%
Multiplan - All Plans	$254 - $413	140%
Ambetter / Centene	$920	507%
Medicaid / KanCare	$920	507%

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 $300.
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 Pinckneyville 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.