Family therapy session
Facility: St Luke Hospital & Living Center
Billing Code: 90847 (CPT)
- CPT Billing Code: 90847
- Insurance Median: $286
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.58x 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 |
|---|---|---|
| Kansas Department Of Health And Environment | $286 | 158% |
| Blue Cross Blue Shield | $286 | 158% |
| Humana | $286 | 158% |
| Va Ccn | $286 | 158% |
| UnitedHealthcare | $286 | 158% |
| Bluestem Pace | $286 | 158% |
| Ambetter / Centene | $288 | 159% |
Consumer Guidance & Cost Commentary
For the CPT code 90847, representing a family therapy session at St Luke Hospital & Living Center in Marion, Kansas, the facility's negotiated rates are consistently $286 across seven major payers, including Blue Cross Blue Shield and Humana. This amount is significantly higher than the Medicare benchmark of $181.34, reflecting a markup of 1.6 times the federal rate. While commercial insurance contracts often include administrative overhead that inflates these prices, patients with high-deductible plans may find that paying the cash price directly could result in lower out-of-pocket costs if the facility offers a self-pay discount. It is important to note that cash prices are not explicitly listed in this report, so contacting the hospital directly to inquire about "self-pay" or "prompt-pay" incentives is essential before scheduling.
The facility, a Critical Access Hospital owned by a Government Hospital District, has a single negotiated rate for this service, meaning there is no variation between different insurance plans in this dataset. However, patients should be aware that commercial negotiated rates frequently exceed the true cost of care as defined by Medicare benchmarks, which serve as a scientifically validated baseline for pricing. If a patient receives care from an out-of-network provider at this facility, they could potentially face balance billing for the difference between the provider's full chargemaster and the insurance allowed amount, though the No Surprises Act protects against such surprise bills for emergency and non-emergency services at in-network facilities. To ensure accuracy, patients should request a full itemized bill to verify that no unbundled codes or services not rendered have been included, as summary bills often obscure these errors.