CMS Price Transparency Data

Family therapy session

Facility: Boston Children's Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90847
  • Insurance Median: $424
  • Cash Discount Price: $595
  • vs. Medicare Baseline: 2.34x Medicare
The contracted insurance negotiated median rate for a Family therapy session at Boston Children's Hospital is $424. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $595. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.34x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.
Cash / Self-Pay
$595

Average discount available for prompt cash payment at this facility.

Insurance Median
$424

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: $595 (328%)
Insurance Median: $424 (234%)
Cash: $595 (328% of Medicare)
Ins. Median: $424 (234% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 234% of the Medicare baseline (a markup of 134%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Cdphp $243 - $590 134%
Harvard Pilgrim $252 - $469 139%
Blue Cross Blue Shield $279 - $458 154%
United $296 - $580 163%
Aetna $297 - $582 164%
Mgb/Allways $301 - $513 166%
Tufts Public Plan $304 - $427 168%
United Ri Nj Ny $312 - $437 172%
Ambetter / Centene $313 - $439 173%
UnitedHealthcare $322 - $590 178%
Carelon Strategies/Bhs $322 - $451 178%
Carelon/Beacon $371 - $520 205%
Fallon $378 - $535 208%
Health New England $400 - $561 221%
Ets/Lifetrac $421 - $590 232%
Interlink Transplant $421 - $590 232%
Cigna $421 - $694 232%
Humana $446 - $625 246%
Community Health Options $446 - $625 246%
Coventry/Hcvm/First Health $455 - $638 251%
Multiplan/Phcs $455 - $659 251%

Consumer Guidance & Cost Commentary

For a family therapy session (CPT 90847) at Boston Children's Hospital, the cash median rate is $595. This facility, located in Boston, MA, is a voluntary non-profit private children's hospital. The Medicare benchmark for this service is $181.34, which serves as the federal government's fixed reimbursement baseline. When comparing rates to the Medicare benchmark, the cash price represents a markup of 2.3 times the Medicare amount.

While the cash rate of $595 is the median, the median negotiated rate for in-network payers is $424. This indicates that for patients with high-deductible plans, paying cash upfront might be more cost-effective if the insurance negotiated rate exceeds the cash price, though the data shows the negotiated rate is lower. Patients should verify their specific plan details and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these can further reduce the final amount owed.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Longwood Avenue, Boston, MA 02115
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens