Family therapy session
Facility: Kiowa District Hospital
Billing Code: 90847 (CPT)
- CPT Billing Code: 90847
- Insurance Median: $238
- Cash Discount Price: $200
- vs. Medicare Baseline: 1.31x 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 |
|---|---|---|
| Tricare | $98 | 54% |
| Blue Cross Blue Shield | $126 | 69% |
| Health Partners Of Ks-All Plans | $220 | 121% |
| Humana | $226 | 125% |
| Healthchoice-All Plans | $230 | 127% |
| Multiplan-All Plans | $235 | 130% |
| Gbs Insurance - All Plans | $235 | 130% |
| Triwest-All Plans | $238 | 131% |
| Medicare (plans) | $238 | 131% |
| UnitedHealthcare | $238 - $250 | 131% |
| Aetna | $238 | 131% |
| Medicaid / KanCare | $250 | 138% |
| Providers Care (Wppa)-All Plans | $375 | 207% |
| Liberty Healthshare-All Plans | $404 | 223% |
Consumer Guidance & Cost Commentary
For CPT code 90847, a family therapy session at Kiowa District Hospital, the facility's cash median price of $200 is lower than the state average of $236. While the hospital's negotiated rates for commercial payers range from $98 to $404, the cash price offers a potential savings for patients with high-deductible plans who may not yet have met their out-of-pocket maximum. It is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures, meaning paying out-of-pocket upfront can sometimes result in a lower total cost than using insurance. Patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing costly claims processing fees.
The facility's Medicare benchmark rate for this service is $181.34, which serves as the objective baseline for evaluating pricing fairness. Commercial negotiated rates for this procedure average between 200% and 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of this benchmark. In this case, the median negotiated amount of $238 aligns closely with the state average of $236, indicating that the facility's pricing is consistent with regional commercial standards. To ensure you are receiving the most accurate pricing, always request a detailed, itemized bill that lists specific CPT codes rather than accepting summary invoices, as over 80% of hospital bills contain errors such as double-billing or unbundled charges that can be corrected through a formal written audit.