CMS Price Transparency Data

Family therapy session

Facility: St Anthony Community Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90847
  • Insurance Median: $341
  • Cash Discount Price: $682
  • vs. Medicare Baseline: 1.88x Medicare
The contracted insurance negotiated median rate for a Family therapy session at St Anthony Community Hospital is $341. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $682. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.88x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.
Cash / Self-Pay
$682

Average discount available for prompt cash payment at this facility.

Insurance Median
$341

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: $682 (376%)
Insurance Median: $341 (188%)
Cash: $682 (376% of Medicare)
Ins. Median: $341 (188% 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.

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
Mvp Gold (McR) $145 80%
Mvp Exchange $160 88%
Mvp Hmo/Ppo $188 104%
Self-Pay - Cc 30% $205 113%
Hamaspik (McR) $220 121%
Medicare (plans) $220 - $236 121%
Tricare $222 122%
Affinity By Molina McR $232 128%
Blue Cross Blue Shield $259 - $341 143%
Self-Pay - Cc 50% $341 188%
Cdphp $341 188%
Aetna $402 - $443 222%
UnitedHealthcare $406 - $478 224%
Emblem Select Care (Exchange) $464 256%
Oxford Exchange $477 263%
PHCS $512 282%
Multiplan $512 282%
Oxford Commercial $546 301%
Emblem Ghi/Hip PPO $546 301%
Emblem Ghi/Hip Hmo/Epo/Pos $546 301%
Magnacare Preferred $614 339%
First Health $682 376%
Geisinger Health Commercial/Exchange $728 401%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals