Family therapy session
Facility: Clay County Medical Center
Billing Code: 90847 (CPT)
- CPT Billing Code: 90847
- Insurance Median: $200
- Cash Discount Price: $305
- vs. Medicare Baseline: 1.10x 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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $195 - $372 | 108% |
| Aetna | $195 - $372 | 108% |
| UnitedHealthcare | $200 | 110% |
| Multiplan- All Plans | $200 - $380 | 110% |
| Health Partners - All Plans | $200 - $380 | 110% |
Consumer Guidance & Cost Commentary
For the CPT code 90847 representing a family therapy session at Clay County Medical Center in Clay Center, KS, the cash median price is $305.00, which matches the gross charge. This cash rate is significantly higher than the state average for this service, as the median negotiated rate across payers is $200.00. While commercial insurance plans like Wppa/Providrs Care, Aetna, and Multiplan have negotiated rates ranging from $195 to $380, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance allowed amount exceeds $305.00. It is important to note that the facility, a Critical Access Hospital owned by the local government, offers a cash median of $305.00, but patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling to potentially lower this amount.
The Medicare benchmark for this procedure is $181.34, and the commercial negotiated rate is approximately 110% higher than this federal baseline. Although the facility's facility rating is 3 out of 5, the pricing structure suggests that commercial contracts often result in higher costs than direct cash payment due to administrative overheads embedded in insurance billing cycles. Patients should be aware that balance billing is generally prohibited for in-network services under federal law, meaning the facility cannot bill you for the difference between their chargemaster and the insurance payment. To ensure you receive the most accurate pricing, always verify your specific plan's deductible status and ask the billing department to confirm whether your insurance will cover the full negotiated rate or if you might face unexpected out