CMS Price Transparency Data

Family therapy session

Facility: St Joseph's Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $293
Cash Discount Price: $248
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Family therapy session at St Joseph's Hospital is $293. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $248. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.62x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.

Cash / Self-Pay

$248

Average discount available for prompt cash payment at this facility.

Insurance Median

$293

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: $248 (137%)

Insurance Median: $293 (162%)

Cash: $248 (137% of Medicare)

Ins. Median: $293 (162% 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
Clear Spring Health of Illinois	$69	38%
Molina Healthcare	$69 - $340	38%
Aetna	$69 - $241	38%
Humana	$69	38%
Sae Hospice	$69	38%
UnitedHealthcare	$69 - $345	38%
Blue Cross Blue Shield	$69	38%
Amish Community	$97	53%
Naphcare	$145	80%
Celtic Insurance Company	$152	84%
Claim Doc	$172	95%
Hopetrust	$172	95%
Wellfirst	$221	122%
Cigna	$231	127%
First Health	$255	141%
Multiplan/Phcs	$293	162%
Healthlink	$293	162%
Provider Network of America	$310	171%
Healthcare Finest Network (Hfn)	$310	171%
Qtc Medical Group of Illinois	$345	190%
Consociate Group	$345	190%
Health Alliance Medical Plans	$345	190%
Current Health Solutions	$345	190%
Illinois Breast and Cervical Cancer Program	$345	190%
Interplan	$345	190%
Mental Health Network	$345	190%
Healthscope	$345	190%
Meridian Health Plan	$356	196%

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 $248.
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 St Joseph's 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.