CMS Price Transparency Data

Family therapy session

Facility: Holton Community Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90847
  • Insurance Median: $344
  • Cash Discount Price: $311
  • vs. Medicare Baseline: 1.90x Medicare
The contracted insurance negotiated median rate for a Family therapy session at Holton Community Hospital is $344. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $311. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.90x the Medicare baseline. Located in 1110 Columbine Drive, Holton, KS.
Cash / Self-Pay
$311

Average discount available for prompt cash payment at this facility.

Insurance Median
$344

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: $311 (172%)
Insurance Median: $344 (190%)
Cash: $311 (172% of Medicare)
Ins. Median: $344 (190% 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.

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
Blue Cross Blue Shield $126 69%
Aetna $220 - $415 121%
UnitedHealthcare $220 - $290 121%
Humana $222 122%
Kansas Superior Select - All Plans $224 124%
Preferred Health Fn Select - All Other Plans $344 190%
Preferred Health Freedom $344 190%
Preferred Health Professionals $344 190%
Wppa Providers - All Plans $394 217%
Medicaid / KanCare $415 229%

Consumer Guidance & Cost Commentary

For the CPT code 90847 representing a family therapy session at Holton Community Hospital in Holton, Kansas, the facility's cash median price of $311.00 is notably lower than the state average of $344.00. While the gross charge is $415.00, insurance negotiated rates vary significantly by payer, ranging from a low of $126.00 with Blue Cross Blue Shield to a high of $415.00 with Medicaid/KanCare. Patients with high-deductible plans may find the cash price more advantageous if their specific insurance negotiated rate exceeds $311.00, as paying out-of-pocket upfront can sometimes result in immediate savings compared to the administrative costs and potential deductibles associated with insurance claims.

To maximize potential savings, consumers should verify if the hospital offers prompt-pay discounts, which can reduce the bill by 20% to 50% for upfront payment within 30 days, effectively bypassing the overhead of insurance billing cycles. It is also important to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Finally, while the facility is in-network for many payers, patients should confirm their specific plan's allowed amount and deductible status before scheduling, as assuming in-network status guarantees the lowest price can lead to unexpected balance billing if the negotiated rate exceeds the patient's financial expectations.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1110 Columbine Drive, Holton, KS 66436
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals