CMS Price Transparency Data

Family therapy session

Facility: Pulaski Memorial Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $269
Cash Discount Price: $287
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Pulaski Memorial Hospital is $269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $287. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.48x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$287

Average discount available for prompt cash payment at this facility.

Insurance Median

$269

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: $287 (158%)

Insurance Median: $269 (148%)

Cash: $287 (158% of Medicare)

Ins. Median: $269 (148% 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
Ambetter / Centene	$127	70%
Blue Cross Blue Shield	$127 - $411	70%
Caresource Mcaid Hip	$127	70%
Caresource Mcare Hmo	$127	70%
Cenpatico Mcaid Hip	$127	70%
Mdwise Mcaid Hip - All Other Plans	$127	70%
Mhs Mcaid Hip	$127	70%
UnitedHealthcare	$127 - $411	70%
Humana	$129 - $330	71%
Mhs Mcare Allwell	$129	71%
Aetna	$148	82%
Caresource Exch Hmo Hix - All Other Plans	$159	88%
Sagamore Rose Acre	$306	169%
Sagamore - All Other Plans	$310	171%
Encore Ppo - All Other Plans	$349	192%
Community Health Alliance - All Plans	$365	201%
Encore Workers Comp	$370	204%
Multiplan - All Plans	$370	204%
Cigna	$390	215%
Caresource Mcaid Hhw	$411	227%
Cenpatico Mcaid Hhw - All Other Plans	$411	227%
Mdwise Mcaid Hcc	$411	227%
Mdwise Mcaid Hhw	$411	227%
Mhs Mcaid Hhw/Hcc	$411	227%

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 $287.
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 Pulaski Memorial 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.