CMS Price Transparency Data

Family therapy session

Facility: Southwest General Health Center

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $156
Cash Discount Price: $240
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Southwest General Health Center is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $240. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.86x the Medicare baseline. Located in 18697 Bagley Road, Middleburg Heights, OH.

Cash / Self-Pay

$240

Average discount available for prompt cash payment at this facility.

Insurance Median

$156

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: $240 (132%)

Insurance Median: $156 (86%)

Cash: $240 (132% of Medicare)

Ins. Median: $156 (86% 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
Medical Mutual	$64 - $66	35%
Medical Mutual-Ohio	$64 - $147	35%
Buckeye	$68 - $201	37%
Caresource	$68 - $160	37%
Humana	$68 - $160	37%
Molina	$68 - $201	37%
UnitedHealthcare	$68 - $173	37%
Amerihealth Caritas	$70 - $160	39%
Healthsmart	$102	56%
Health Design Plus	$118	65%
Clarity Health	$128	71%
Healthspan	$128	71%
Healthsmart Preferred	$144	79%
Blue Cross Blue Shield	$147 - $196	81%
Valor Health	$147	81%
Ohio Health Choice Plus	$155	85%
Aetna	$173	95%
Summacare	$173	95%
Cigna	$175	97%
Coventry	$221	122%
First Health	$221	122%
Ohio Health Choice	$247	136%
Private Healthare Systems	$256	141%

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 $240.
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 Southwest General Health Center 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.