CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $401
Cash Discount Price: $500
vs. Medicare Baseline: 2.21x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at UMass Memorial Health - Harrington Hospital is $401. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $500. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.21x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$500

Average discount available for prompt cash payment at this facility.

Insurance Median

$401

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: $500 (276%)

Insurance Median: $401 (221%)

Cash: $500 (276% of Medicare)

Ins. Median: $401 (221% 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 221% of the Medicare baseline (a markup of 121%). 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%
Champva [11001]	$93	51%
Wellpoint [11112]	$104 - $368	57%
Fallon Mcaid Carelon Hlth [29]	$114 - $500	63%
Wellsense Mcaid Carelon Hlth [21]	$114 - $500	63%
Workers Compensation [20501]	$244	135%
Medicaid / KanCare	$260	143%
Hne [11108]	$325	179%
Cigna	$355 - $389	196%
Tufts [11201]	$355	196%
First Health Network [11120]	$375	207%
Evernorth Behavioral Health [27]	$400	221%
Aetna	$402 - $500	222%
Harvard Pilgrim [10701]	$410	226%
UnitedHealthcare	$425 - $500	234%
Fallon Connectorcare [10503]	$473	261%
Connecticare [11105]	$500	276%
Fallon Carelon Hlth [28]	$500	276%
Grants [20507]	$500	276%
Masshealth Mcd Mbhp [38]	$500	276%
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 $500.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90834.

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 90834.
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.