CMS Price Transparency Data

Family therapy session

Facility: Licking Memorial Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $255
Cash Discount Price: $284
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Family therapy session at Licking Memorial Hospital is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $284. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.41x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.

Cash / Self-Pay

$284

Average discount available for prompt cash payment at this facility.

Insurance Median

$255

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: $284 (157%)

Insurance Median: $255 (141%)

Cash: $284 (157% of Medicare)

Ins. Median: $255 (141% 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
Medical Mutual [100114]	$156 - $236	86%
Blue Cross Blue Shield	$182 - $244	100%
Medben [700068]	$199 - $278	110%
Benicomp [70090]	$213	117%
Consociate Health 6 Degrees [100059]	$227	125%
Consociate Health [100029]	$227	125%
Allied Benefit Systems [100015]	$232	128%
Trustmark Small Business Benefits [100263]	$232	128%
Webtpa [100127]	$232	128%
Meritain [100063]	$232	128%
Gravie Administrative Services [100165]	$232	128%
Optima [700069]	$232	128%
Aetna	$232 - $234	128%
Geha [100039]	$232	128%
The Health Plan [100261]	$255	141%
Ohio Healthy [100255]	$255	141%
Ohio PPO Connect [70006801]	$255	141%
Ohio Healthy Luminare Health [100264]	$255	141%
Great West Life [700064]	$255	141%
National Association of Letter Carriers [100067]	$255	141%
Osu Prime Care [100254]	$255	141%
Coresource [100002]	$255 - $284	141%
Quality Care Partners [70006802]	$255	141%
Antidote Health Plan of Ohio [70006803]	$255	141%
Wellfleet Group, LLC [100164]	$255	141%
Cigna	$255	141%
American Postal Workers [100089]	$255	141%
Pan American Life [700070]	$262	144%
Coventry [100010]	$262	144%
Ohio Health Choice [100109]	$272	150%
Administrative Concepts [100006]	$275	152%
Humana	$275	152%
Philadelphia American Life [100260]	$275 - $284	152%
Carefactor [100087]	$275	152%
Reliance Standard-Asrm [100258]	$275	152%
Healthscope [100157]	$284	157%
Surest [100016]	$284	157%
United Medical Resources [700071]	$284	157%
UnitedHealthcare	$284	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 $284.
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 Licking Memorial 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.