CMS Price Transparency Data

Care planning with family

Facility: Nemaha Valley Community Hospital

Billing Code: 90887 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90887
Insurance Median: $46
Cash Discount Price: $45
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Care planning with family at Nemaha Valley Community Hospital is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1600 Community Dr, Seneca, KS.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

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 (%)

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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	$22	N/A
Partners Direct Health - All Plans	$26	N/A
Aetna	$42 - $329	N/A
Multiplan - All Plans	$45	N/A
Health Partners - All Plans	$48	N/A
Midlands Choice - All Plans	$48	N/A
Celtic Comm Exch - All Plans	$329	N/A

Consumer Guidance & Cost Commentary

For the CPT code 90887, "Care planning with family," Nemaha Valley Community Hospital in Seneca, KS, lists a gross charge of $50.00. The facility offers a cash median price of $45.00 and a median negotiated rate of $46.00, which is slightly higher than the cash price. While the data does not provide specific county or state average comparisons for this specific code, patients should be aware that cash-pay options can sometimes be more cost-effective than insurance claims, particularly for those with high-deductible plans where the insurer's negotiated rate might exceed the cash price. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can reduce the final amount owed.

Insurance coverage for this service varies significantly among payers, with negotiated rates ranging from $22.00 for Humana and Partners Direct Health to $329.00 for Celtic Comm Exch - All Plans. This wide disparity highlights the importance of verifying your specific plan's allowed amount before receiving care. Under federal protections like the No Surprises Act, patients are generally shielded from balance billing for out-of-network services at in-network facilities, though unexpected ancillary charges can still occur. If you receive a bill that seems inconsistent with your plan's allowed amount, you should request a formal itemized billing audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies that can be corrected through written dispute.

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 $45.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90887.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Nemaha Valley Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90887.
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.