UMass Memorial Health Care · Worcester, MA
235
Disclosed rate categories
50
Beds
3
Care quality
Umass Memorial Childrens Medical Center is a 50-bed voluntary non-profit - private hospital in Worcester, MA, affiliated with UMass Memorial Health Care. Below you'll find publicly disclosed negotiated rates and facility details, including 235 disclosed rate categories.
CCN (Medicare provider number)
220163
NPI
1891115861
Type
Childrens Hospital
Ownership
Voluntary Non-Profit - Private
Beds
50
Care Quality
3
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Umass Memorial Childrens Medical Center most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
CT imaging
CPT 74177
$1,127 - $4,016
from 4 insurers · median $3,383
Common here, based on CMS Medicare volume
Gynecology
CPT 58558
$2,446 - $5,784
from 3 insurers · median $5,472
90 Medicare claims in Level 4 Gynecologic Procedures (CMS 2024)
CT imaging
CPT 70450
$328 - $1,828
from 4 insurers · median $1,197
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 470
$22,370 - $50,082
from 4 insurers · median $39,579
91 Medicare discharges for this DRG in CMS hospital data
CT imaging
CPT 74176
$650 - $3,886
from 4 insurers · median $2,983
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$373 - $592
from 4 insurers · median $458
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$969 - $2,257
from 4 insurers · median $1,954
Common here, based on CMS Medicare volume
CT imaging
CPT 71260
$589 - $2,731
from 4 insurers · median $1,934
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 216
$186,381 - $284,897
from 3 insurers · median $211,481
11 Medicare discharges for this DRG in CMS hospital data
MRI imaging
CPT 70553
$1,127 - $4,161
from 4 insurers · median $2,894
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$150 - $483
from 4 insurers · median $315
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$2,008 - $4,771
from 3 insurers · median $4,219
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$2,134 - $4,771
from 3 insurers · median $4,219
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$3,589 - $5,656
from 4 insurers · median $4,974
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$344 - $4,771
from 4 insurers · median $3,142
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$5,256 - $13,497
from 4 insurers · median $7,156
250 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
MRI imaging
CPT 74183
$1,127 - $3,750
from 4 insurers · median $3,170
Common here, based on CMS Medicare volume
Ultrasound
CPT 76856
$322 - $1,067
from 4 insurers · median $846
Common here, based on CMS Medicare volume
MRI imaging
CPT 72148
$645 - $2,817
from 4 insurers · median $2,621
Common here, based on CMS Medicare volume
Urology
CPT 52000
$1,343 - $3,617
from 3 insurers · median $3,564
1017 Medicare claims in Level 2 Urology and Related Services (CMS 2024)
Gynecology
CPT 58571
$7,768 - $13,497
from 2 insurers · median $10,632
109 Medicare claims in Level 2 Laparoscopy and Related Services (CMS 2024)
MRI imaging
CPT 70551
$673 - $2,817
from 4 insurers · median $2,493
Common here, based on CMS Medicare volume
Ear, nose and throat
CPT 69436
$1,103 - $5,472
from 4 insurers · median $2,841
54 Medicare claims in Level 3 ENT Procedures (CMS 2024)
Ultrasound
CPT 76830
$296 - $827
from 4 insurers · median $716
Common here, based on CMS Medicare volume
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 24 | 559% | 19 | 3 |
| Insurer B* | 23 | 515% | 6 | 0 |
| Insurer C* | 24 | 472% | 17 | 6 |
| Insurer D* | 18 | 276% | 15 | 1 |
How we chose these services: 7 appear in this hospital's own Medicare claims, 17 are common here based on CMS Medicare volume, and 0 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Umass Memorial Childrens Medical Center.
55 Lake Ave N, Worcester, MA 1655
None
The nearest hospitals of similar type and size. Their rates are compared with Umass Memorial Childrens Medical Center for the same insurers and services above.
Saint Vincent Hospital
▼ Rates typically 56% lower than Umass Memorial Childrens Medical Center (24 services)
Landmark Medical Center
▼ Rates typically 29% lower than Umass Memorial Childrens Medical Center (24 services)
Newton Wellesley Hospital
▼ Rates typically 54% lower than Umass Memorial Childrens Medical Center (20 services)
Norwood Hospital
▼ Rates typically 60% lower than Umass Memorial Childrens Medical Center (16 services)
Smg Neurology At St. Elizabeth S Medical Center
▼ Rates typically 46% lower than Umass Memorial Childrens Medical Center (24 services)
Lahey Clinic Hospital Inc.
▼ Rates typically 28% lower than Umass Memorial Childrens Medical Center (24 services)
Shriners Hospitals For Children — Springfield
Shriners Hospitals For Children — Boston
Boston Children S Hospital
Franciscan Children S
About Umass Memorial Childrens Medical Center's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Umass Memorial Childrens Medical Center range from $1,127 to $4,161 across 4 insurers. Blue Cross Blue Shield's rate is $1,127. The median at nearby comparable hospitals is $881. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Umass Memorial Childrens Medical Center range from $1,127 to $4,016 across 4 insurers. Aetna's rate is $3,210. The median at nearby comparable hospitals is $984. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with biopsy (CPT 45380), published negotiated rates at Umass Memorial Childrens Medical Center range from $2,134 to $4,771 across 3 insurers. UnitedHealthcare's rate is $4,219. The median at nearby comparable hospitals is $3,611. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Umass Memorial Childrens Medical Center range from $373 to $592 across 4 insurers. Cigna's rate is $429. The median at nearby comparable hospitals is $270. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Umass Memorial Childrens Medical Center range from $22,370 to $50,082 across 4 insurers. Cigna's rate is $42,097. The median at nearby comparable hospitals is $20,986. What a patient pays depends on their plan's deductible, coinsurance and network status.
Umass Memorial Childrens Medical Center has 50 beds. Facility type: Childrens Hospital.
Umass Memorial Childrens Medical Center is located at 55 Lake Ave N, Worcester, MA 1655. Its main phone number is None.
Umass Memorial Childrens Medical Center's CMS Certification Number (CCN), also called its Medicare provider number, is 220163.
The National Provider Identifier (NPI) on file for Umass Memorial Childrens Medical Center is 1891115861.
Umass Memorial Childrens Medical Center is affiliated with UMass Memorial Health Care.
235 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers