Family therapy session
Facility: Nemaha Valley Community Hospital
Billing Code: 90847 (CPT)
- CPT Billing Code: 90847
- Insurance Median: $140
- Cash Discount Price: $140
- vs. Medicare Baseline: 0.77x 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.
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 |
|---|---|---|
| Humana | $68 | 37% |
| Partners Direct Health - All Plans | $81 | 45% |
| Blue Cross Blue Shield | $127 | 70% |
| Aetna | $132 - $329 | 73% |
| Multiplan - All Plans | $140 | 77% |
| Midlands Choice - All Plans | $147 | 81% |
| Health Partners - All Plans | $147 | 81% |
| Celtic Comm Exch - All Plans | $329 | 181% |
Consumer Guidance & Cost Commentary
For the CPT code 90847, representing a family therapy session at Nemaha Valley Community Hospital in Seneca, KS, the cash median price is $140.00, which aligns with the facility's median negotiated rate of $140.00. This cash price is notably lower than the Medicare benchmark amount of $181.34, suggesting that for patients with high-deductible plans, paying out-of-pocket may result in lower out-of-pocket costs compared to using insurance, as commercial negotiated rates often exceed cash prices. While the facility is a Critical Access Hospital owned by a voluntary non-profit, patients should verify their specific plan's allowed amount, as some in-network contracts may still result in higher charges than the cash rate if deductibles have not been met.
The pricing data for this service shows significant variation among payers, with Humana and Partners Direct Health having a single plan rate of $68.00, while Aetna's two plans range from $127.00 to $329.00. Because the facility is in-network for these carriers, the No Surprises Act protects patients from balance billing for out-of-network providers at this location, though emergency or ancillary services might still trigger unexpected charges. To maximize savings, patients should request a prompt-pay discount before scheduling, which can reduce the bill by 20% to 50% if paid in full upfront, effectively bypassing the administrative overhead and delayed reimbursement cycles associated with insurance claims.