CMS Price Transparency Data

Family therapy session

Facility: Mercy Hospital of Buffalo

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90847
  • Insurance Median: $101
  • Cash Discount Price: $324
  • vs. Medicare Baseline: 0.56x Medicare
The contracted insurance negotiated median rate for a Family therapy session at Mercy Hospital of Buffalo is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $324. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.56x the Medicare baseline. Located in 565 Abbott Road, Buffalo, NY.
Cash / Self-Pay
$324

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $324 (179%)
Insurance Median: $101 (56%)
Cash: $324 (179% of Medicare)
Ins. Median: $101 (56% 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.

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
UnitedHealthcare $70 - $116 39%
Tuscarora Nation [550120] $75 - $89 41%
Medicaid / KanCare $75 - $101 41%
Univera Healthcare Essential [100170] $83 - $84 46%
Univera Healthcare [100169] $83 - $123 46%
Blue Cross Blue Shield $85 - $110 47%
Amerigroup [350102] $86 - $89 47%
Vna Option Mltc [350110] $86 - $89 47%
Excellus Rochester McD [350117] $86 - $89 47%
Crime Victims [100176] $86 - $89 47%
Independent Health Essential [100166] $89 49%
Beacon Essential [350122] $90 - $120 50%
VA Veterans Affairs [700001] $90 - $101 50%
Fidelis Essential [100163] $91 - $121 50%
Mvp Healthcare [100168] $92 - $131 51%
Medicare (plans) $99 - $110 55%
Seneca Nation [450119] $100 - $101 55%
Fallon Health [450115] $100 - $101 55%
Hospice [550001] $100 - $101 55%
Champ VA [700002] $100 - $101 55%
Cigna $100 - $146 55%
Covid19 Hrsa [45013] $100 - $101 55%
Tricare $100 - $101 55%
Catholic Health Life Pace [400005] $100 - $101 55%
Meritain [100063] $101 56%
Humana $101 - $105 56%
Aetna $101 - $105 56%
Magnacare [100142] $101 56%
Fidelis Dual Advantage [450120] $105 - $106 58%
Wellcare Fidelis Dual [450451] $105 - $106 58%
Ghi [100153] $110 - $111 61%
Wellcare [450129] $110 - $111 61%
UPMC Health Plan [100181] $114 - $181 63%
Independent Health [100165] $115 63%
Iha First Choice [800001] $115 63%
Fidelis Exchange [100164] $120 - $121 66%
Beacon Health Options [100023] $120 66%
No Fault [114001] $182 100%
Federal Workers Compensation [500100] $182 100%
Molina Essential [100167] $193 - $199 106%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 565 Abbott Road, Buffalo, NY 14220
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals