CMS Price Transparency Data

Family therapy session

Facility: West Penn Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $94
Cash Discount Price: $81
vs. Medicare Baseline: 0.52x Medicare

The contracted insurance negotiated median rate for a Family therapy session at West Penn Hospital is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.52x the Medicare baseline. Located in 4800 Friendship Avenue, Pittsburgh, PA.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$94

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: $81 (45%)

Insurance Median: $94 (52%)

Cash: $81 (45% of Medicare)

Ins. Median: $94 (52% 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
Carelon	$16 - $31	9%
UnitedHealthcare	$21 - $542	12%
Community Care Behavorial Health Healthchoices	$24 - $94	13%
Community Care Behavorial Health University Of Pittsburgh Medical Center	$24 - $94	13%
Highmark	$93 - $392	51%
Life Pittsburgh	$100 - $155	55%
Medicare (plans)	$106 - $159	58%
American Health Plans	$111 - $155	61%
Martin'S Point	$155	85%
Aetna	$161 - $512	89%
Amerihealth	$162	89%
Highmark Wholecare	$164	90%
Humana	$164	90%
Cigna	$165 - $513	91%
Molina	$168	93%
Medical Mutual	$513	283%

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 $81.
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 West Penn 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.