CMS Price Transparency Data

Behavioral health assessment

Facility: Cheshire Medical Center

Billing Code: H0001 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: H0001
Insurance Median: $315
Cash Discount Price: $160
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Behavioral health assessment at Cheshire Medical Center is $315. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$160

Average discount available for prompt cash payment at this facility.

Insurance Median

$315

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

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
Mvp	$8 - $288	N/A
Cigna	$8 - $288	N/A
Amerihealth Caritas Nh	$71 - $170	N/A
Wellsense Health Plan	$80 - $170	N/A
Granite State Health Plan	$97 - $170	N/A
Harvard Pilgrim Health Care of Ne	$124 - $264	N/A
Aetna	$157 - $397	N/A
Maine Community Health Options	$261	N/A
UnitedHealthcare	$343 - $441	N/A
Tufts Health Plan	$371	N/A
Blue Cross Blue Shield	$445 - $462	N/A
First Health/Hcvm	$494	N/A
PHCS	$523	N/A
Mass General Brigham Health Plan	$581	N/A

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 $160.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: H0001.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cheshire Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code H0001.
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.