CMS Price Transparency Data

Family therapy session

Facility: Sanford Hillsboro

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $697
Cash Discount Price: $676
vs. Medicare Baseline: 3.84x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Sanford Hillsboro is $697. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $676. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 3.84x the Medicare baseline. Located in 12 Third Street Se, Hillsboro, ND.

Cash / Self-Pay

$676

Average discount available for prompt cash payment at this facility.

Insurance Median

$697

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: $676 (373%)

Insurance Median: $697 (384%)

Cash: $676 (373% of Medicare)

Ins. Median: $697 (384% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 384% of the Medicare baseline (a markup of 284%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$205 - $782	113%
Sanford Health Plan Align	$385	212%
Ucare	$414 - $742	228%
Aetna	$417 - $734	230%
Health Partners	$417 - $659	230%
Medicare (plans)	$417	230%
UnitedHealthcare	$417 - $706	230%
Primewest	$426	235%
Security Health Plan	$465	256%
Sanford Health Plan	$667 - $785	368%
Medica	$697 - $745	384%
First Choice Health Network	$760	419%
Healthez	$760	419%
Multiplan	$760	419%

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 $676.
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 Sanford Hillsboro 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.