CMS Price Transparency Data

Family therapy session

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90847
Insurance Median: $535
Cash Discount Price: $659
vs. Medicare Baseline: 2.95x Medicare

The contracted insurance negotiated median rate for a Family therapy session at UMass Memorial Health - Harrington Hospital is $535. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $659. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.95x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$659

Average discount available for prompt cash payment at this facility.

Insurance Median

$535

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: $659 (363%)

Insurance Median: $535 (295%)

Cash: $659 (363% of Medicare)

Ins. Median: $535 (295% 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 295% of the Medicare baseline (a markup of 195%). 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
Blue Cross Blue Shield	$29 - $32	16%
Workers Compensation [20501]	$89	49%
Champva [11001]	$104	57%
Medicaid / KanCare	$343	189%
Hne [11108]	$429	237%
Cigna	$468 - $513	258%
Tufts [11201]	$468	258%
Fallon Connectorcare [10503]	$474	261%
Wellpoint [11112]	$485	267%
First Health Network [11120]	$494	272%
Evernorth Behavioral Health [27]	$527	291%
Aetna	$530 - $659	292%
Harvard Pilgrim [10701]	$540	298%
UnitedHealthcare	$560 - $659	309%
Connecticare [11105]	$659	363%
Fallon Carelon Hlth [28]	$659	363%
Fallon Mcaid Carelon Hlth [29]	$659	363%
Grants [20507]	$659	363%
Masshealth Mcd Mbhp [38]	$659	363%
Wellsense Mcaid Carelon Hlth [21]	$659	363%
Hsno/Free Care [10801]	$681	376%

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 $659.
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 UMass Memorial Health - Harrington 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.