CMS Price Transparency Data

Family therapy session

Facility: M Health Fairview St John's Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $356
Cash Discount Price: $219
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a Family therapy session at M Health Fairview St John's Hospital is $356. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $219. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.96x the Medicare baseline. Located in 1575 Beam Avenue, Maplewood, MN.

Cash / Self-Pay

$219

Average discount available for prompt cash payment at this facility.

Insurance Median

$356

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)

Cash / Self-Pay: $219 (121%)

Insurance Median: $356 (196%)

Cash: $219 (121% of Medicare)

Ins. Median: $356 (196% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medica	$84 - $462	46%
Blue Cross Blue Shield	$90 - $347	50%
Health Partners	$90 - $362	50%
Itasca Medical Care	$90 - $156	50%
Primewest	$90 - $156	50%
South Country Health Alliance	$90 - $156	50%
Ucare	$91 - $359	50%
Sanford Health Plan	$100 - $424	55%
Security Health Plan	$100 - $540	55%
UnitedHealthcare	$100 - $525	55%
Wellcare	$100 - $156	55%
Hennepin Health	$113 - $162	62%
America'S Ppo	$230 - $518	127%
First Health	$362 - $590	200%
Multiplan	$376 - $612	207%
Private Healthcare Systems	$376 - $612	207%
Wisconsin Physician Services	$398 - $648	219%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $219.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90847.

Insurance In-Network Protection Plan

Contact your insurance company to confirm M Health Fairview St John's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90847.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.