Family therapy session
Facility: Trego County Lemke Memorial Hospital
Billing Code: 90847 (CPT)
- CPT Billing Code: 90847
- Insurance Median: $576
- Cash Discount Price: $718
- vs. Medicare Baseline: 3.18x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 318% of the Medicare baseline (a markup of 218%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $174 | 96% |
| Humana | $414 | 228% |
| Tricare | $447 | 246% |
| Aetna | $524 - $760 | 289% |
| UnitedHealthcare | $524 - $845 | 289% |
| Medicaid / KanCare | $524 - $845 | 289% |
| Ambetter / Centene | $576 | 318% |
| Health Partners - All Plans | $803 | 443% |
| Healthy Blue Mcaid - All Plans | $845 | 466% |
Consumer Guidance & Cost Commentary
For the CPT code 90847, representing a family therapy session at Trego County Lemke Memorial Hospital in Wakeeney, KS, the facility's cash median rate is $718.00, which is notably higher than the state average of $524.00. While the hospital is a Critical Access Hospital owned by the local government, patients should be aware that paying out-of-pocket can sometimes be more expensive than using insurance if the negotiated rate exceeds the cash price. However, for those with high-deductible plans, the cash rate of $718.00 may still be preferable to the median negotiated rate of $576.00 if the patient's insurance deductible has not yet been met, as the insurance company would likely pay the full negotiated amount before the patient's personal funds are applied.
The data indicates significant variation in pricing across different payers, with rates ranging from a low of $174 for Blue Cross Blue Shield to a high of $845 for UnitedHealthcare and Medicaid/KanCare plans. Because the facility is in-network for most of these payers, patients are protected from balance billing for emergency care under the No Surprises Act, though they should still request an itemized bill to ensure no unbundled charges or services not rendered are included. To minimize costs, patients are encouraged to contact the hospital directly to inquire about prompt-pay discounts, which can offer a fee reduction for upfront payment, and to verify their specific plan's allowed amount before scheduling the session.