Family therapy session
Facility: Fredonia Regional Hospital
Billing Code: 90847 (CPT)
- CPT Billing Code: 90847
- Insurance Median: $351
- Cash Discount Price: $390
- vs. Medicare Baseline: 1.94x 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 | $127 - $193 | 70% |
| Veterans Programs - All Plans | $199 | 110% |
| Aetna | $199 - $351 | 110% |
| UnitedHealthcare | $351 | 194% |
| Meritain-All Plans | $351 | 194% |
| Reserve National-All Plans | $351 | 194% |
| Cigna | $351 | 194% |
Consumer Guidance & Cost Commentary
For the CPT code 90847, representing a family therapy session at Fredonia Regional Hospital in Fredonia, Kansas, the cash median price is $390.00. This cash rate aligns exactly with the facility's gross charge and the median amount paid by patients without insurance. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that paying cash upfront can sometimes be more cost-effective than using insurance, particularly if their plan has a high deductible or if the insurance negotiated rate exceeds the cash price. In this specific case, the median negotiated rate across seven payers is $351.00, which is lower than the cash price, suggesting that utilizing an in-network plan may result in lower out-of-pocket costs for most members.
It is important to distinguish between the facility's gross charges and the actual amounts billed to patients, as commercial rates often include administrative overhead that can inflate the baseline price. Although the data does not provide explicit county or state average comparisons for this specific code, the facility's Medicare benchmark of $181.34 serves as a critical reference point, indicating that commercial negotiated rates are significantly higher than the federal baseline. Patients should verify their specific plan details before scheduling, as assuming that being in-network guarantees the lowest possible price can be misleading, as different insurers negotiate varying rates. Additionally, if you encounter a surprise bill that exceeds the allowed amount, you may be eligible for protections under the No Surprises Act, which bans balance billing for out-of-network services at in-network facilities.