CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $465
Cash Discount Price: $838
vs. Medicare Baseline: 2.56x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at UMass Memorial Healthalliance Hospitals is $465. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $838. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.56x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$838

Average discount available for prompt cash payment at this facility.

Insurance Median

$465

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: $838 (462%)

Insurance Median: $465 (256%)

Cash: $838 (462% of Medicare)

Ins. Median: $465 (256% 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 256% of the Medicare baseline (a markup of 156%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Tufts [11201]	$28	15%
Cigna	$30 - $863	17%
Blue Cross Blue Shield	$32 - $236	18%
Medicaid / KanCare	$101 - $474	56%
Champva [11001]	$138	76%
Workers Compensation [20501]	$251 - $299	138%
UnitedHealthcare	$259 - $309	143%
Hsno/Free Care [10801]	$294	162%
Harvard Pilgrim [10701]	$382 - $456	211%
Institution [10406]	$405 - $483	223%
Hne [11108]	$426 - $508	235%
Aetna	$500 - $596	276%
Wellpoint [11112]	$563 - $671	310%
First Health Network [11120]	$573 - $683	316%
Multiplan [11109]	$573 - $683	316%
Fallon Connectorcare [10503]	$691	381%
Connecticare [11105]	$764 - $911	421%
Fallon Carelon Hlth [28]	$764 - $911	421%
Fallon Mcaid Carelon Hlth [29]	$764 - $911	421%
Grants [20507]	$764 - $911	421%

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 $838.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90837.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UMass Memorial Healthalliance Hospitals is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90837.
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.