CMS Price Transparency Data

Family therapy session

Facility: Alice Peck Day Memorial Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $134
Cash Discount Price: $100
vs. Medicare Baseline: 0.74x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Alice Peck Day Memorial Hospital is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.74x the Medicare baseline. Located in 10 Alice Peck Day Drive, Lebanon, NH.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$134

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: $100 (55%)

Insurance Median: $134 (74%)

Cash: $100 (55% of Medicare)

Ins. Median: $134 (74% 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
Ambetter / Centene	$35	19%
Nh Healthy Families	$36	20%
Medicaid / KanCare	$68 - $102	37%
Blue Cross Blue Shield	$73 - $198	40%
Harvard Pilgrim	$92 - $192	51%
UnitedHealthcare	$107 - $160	59%
Tufts	$109 - $163	60%
Cigna	$113 - $182	62%
Commercial Generic	$113 - $170	62%
Connecticut General	$113 - $170	62%
Klais	$114 - $172	63%
Wellpoint	$116 - $174	64%
Aetna	$133 - $200	73%
Mvp	$135 - $202	74%
Coventry Health	$141 - $211	78%
Coventry Health Wc	$141 - $211	78%
Humana	$154 - $231	85%

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 $100.
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 Alice Peck Day Memorial 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.