CMS Price Transparency Data

Family therapy session

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $159
Cash Discount Price: $222
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Nationwide Children's Hospital Toledo, LLC is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $222. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.88x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$222

Average discount available for prompt cash payment at this facility.

Insurance Median

$159

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: $222 (122%)

Insurance Median: $159 (88%)

Cash: $222 (122% of Medicare)

Ins. Median: $159 (88% 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
Mcclaren Health Plan - Michigan	$60 - $187	33%
Caresource	$70 - $190	39%
UnitedHealthcare	$70 - $187	39%
Amerihealth	$71 - $159	39%
Bchp	$71 - $159	39%
Mmo	$92 - $262	51%
Tricare	$97	53%
Paramount	$102	56%
Blue Cross Blue Shield	$107 - $189	59%
Front Path Health Coalition	$136 - $166	75%
Aetna	$142 - $179	78%
Mcclaren Health Plan	$143 - $166	79%
Cigna	$147 - $320	81%
Molina	$157 - $193	87%
Humana	$159	88%
Ohc	$185 - $328	102%
Ohio Ppo Connect	$185 - $328	102%
First Health	$285	157%

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 $222.
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 Nationwide Children's Hospital Toledo, LLC 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.