CMS Price Transparency Data

Family therapy session

Facility: Fayette County Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $343
Cash Discount Price: $527
vs. Medicare Baseline: 1.89x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Fayette County Hospital is $343. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $527. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.89x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.

Cash / Self-Pay

$527

Average discount available for prompt cash payment at this facility.

Insurance Median

$343

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: $527 (291%)

Insurance Median: $343 (189%)

Cash: $527 (291% of Medicare)

Ins. Median: $343 (189% 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
Health Alliance Mcare	$169	93%
Healthlink Mcr Adv	$169	93%
Humana	$169	93%
Aetna	$332 - $364	183%
Blue Cross Blue Shield	$332 - $443	183%
Illinicare - All Plans	$332	183%
Medicaid / KanCare	$332	183%
Meridian-All Plans	$332	183%
Coventry/Ghp-All Plans	$343	189%
Healthlink Hmo	$369	203%
Cigna	$395	218%
Healthlink Ppo - All Other Plans	$422	233%
Health Alliance - All Other Plans	$435	240%
UnitedHealthcare	$437	241%
Multiplan - All Plans	$448	247%

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 $527.
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 Fayette 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.