Family therapy session
Facility: Kansas City Orthopaedic Institute
Billing Code: 90847 (CPT)
- CPT Billing Code: 90847
- Insurance Median: $368
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.03x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 203% of the Medicare baseline (a markup of 103%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 | $142 | 78% |
| UnitedHealthcare | $142 | 78% |
| Cigna | $151 | 83% |
| Blue Cross Blue Shield | $368 | 203% |
Consumer Guidance & Cost Commentary
For the CPT code 90847, representing a family therapy session at the Kansas City Orthopaedic Institute in Leawood, KS, the negotiated rates vary significantly by insurer. While Aetna, UnitedHealthcare, and Cigna each have a single plan paying exactly $142, $142, and $151 respectively, Blue Cross Blue Shield has five plans paying $368. This facility is owned by a physician and is classified as an Acute Care Hospital. The data indicates that the median negotiated rate of $368 is substantially higher than the cash price, which is not available in this dataset. Patients should be aware that while in-network insurance provides coverage, the specific allowed amount can vary widely depending on the individual plan within the same carrier network.
To minimize out-of-pocket costs, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, as paying cash upfront can sometimes result in a lower total than the insurance negotiated rate, particularly for those with high-deductible plans. It is also important to request an itemized bill before finalizing payment, as summary bills may obscure individual charges or include unbundled codes that should be consolidated. Since the facility is located in Leawood, KS (ZIP 66211), patients should compare these specific negotiated amounts against local state averages to ensure they are receiving fair pricing, keeping in mind that commercial rates often exceed the Medicare benchmark of $181.34 for this procedure.