Family therapy session
Facility: Hiawatha Community Hospital
Billing Code: 90847 (CPT)
- CPT Billing Code: 90847
- Insurance Median: $327
- Cash Discount Price: $420
- vs. Medicare Baseline: 1.80x 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 |
|---|---|---|
| Blue Cross Blue Shield | $121 - $127 | 67% |
| Aetna | $155 - $339 | 85% |
| UnitedHealthcare | $155 - $361 | 85% |
| Humana | $157 | 87% |
| Ambetter / Centene | $186 | 103% |
| Centrus Health Direct - All Plans | $315 | 174% |
| Oscar - All Plans | $315 | 174% |
| Preferred Hlth - All Plans | $378 | 208% |
| Wppa Providrs Care - All Plans | $399 | 220% |
| Cigna | $399 | 220% |
| Multiplan - All Plans | $407 | 224% |
| Midlands Choice - All Plans | $407 | 224% |
| Healthy Blue Mcaid - All Plans | $420 | 232% |
Consumer Guidance & Cost Commentary
For the family therapy session (CPT 90847) at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $420.00, which matches the facility's gross charge and the median paid by cash payers. This rate is significantly higher than the state average, as indicated by a markup factor of 1.8 times the Medicare benchmark of $181.34. While commercial insurance plans like Blue Cross Blue Shield and Aetna negotiate rates ranging from $121 to $399, these negotiated amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying the cash price of $420.00 directly may result in lower out-of-pocket costs compared to the insurance negotiated rates, provided the patient has not yet met their deductible.
Patients should verify if the facility offers self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is important to note that the median negotiated rate across all payers is $327.00, which is lower than the cash price but may still be higher than the actual cost to the patient depending on their specific plan coverage. To ensure transparency, consumers should request an itemized billing audit to confirm that no services were unbundled or incorrectly charged, as over 80% of hospital bills contain errors. Finally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, though they should still review their itemized statement carefully before finalizing payment.