Family therapy session
Facility: Wamego Health Center
Billing Code: 90847 (CPT)
- CPT Billing Code: 90847
- Insurance Median: $119
- Cash Discount Price: $154
- vs. Medicare Baseline: 0.66x 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 |
|---|---|---|
| UnitedHealthcare | $74 - $114 | 41% |
| Aetna | $77 - $119 | 42% |
| Medicaid / KanCare | $77 - $120 | 42% |
| Providrs Care | $125 | 69% |
| Tricare | $128 | 71% |
| Blue Cross Blue Shield | $167 - $176 | 92% |
Consumer Guidance & Cost Commentary
For the CPT code 90847, representing a family therapy session at Wamego Health Center in Wamego, KS, the facility's cash median rate is $154.00. This cash price is notably lower than the facility's negotiated rates, which range from $74 to $176 depending on the payer. For instance, Medicaid/KanCare plans negotiated a rate of $125, while Blue Cross Blue Shield plans negotiated up to $167. Patients with high-deductible plans may find paying the cash price of $154.00 more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that while the facility is a Critical Access Hospital, specific negotiated rates vary significantly by insurer, with UnitedHealthcare and Aetna plans falling in the $74 to $119 range.
When evaluating the cost of this service, it is essential to compare these rates against the Medicare benchmark to understand the true cost basis. The Medicare amount for this procedure is $181.34, which serves as a scientifically validated baseline for healthcare delivery. The facility's cash rate of $154.00 is approximately 85% of the Medicare rate, indicating a pricing structure that is below the federal benchmark. Conversely, the highest negotiated rate of $176 for Tricare exceeds the Medicare amount. Consumers should be aware that hospitals often inflate their chargemaster lists to make discounts appear larger; therefore, comparing rates to the Medicare amount rather than the gross list price provides a clearer picture of value. Additionally, patients should inquire about prompt-pay discounts before scheduling, as paying