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Office visit, new patient, 60-74 min

CPT 99205 · negotiated-rate distribution across hospitals in MA

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Hospitals
12
Min
$147.68
Median
$222.75
Max
$523.64
Range multiplier
3.5×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare753$77.29$169.61$855.1411.1×
institution [10406]449$120.84$228$5864.8×
Blue Cross Blue Shield744$20$227.59$755.0337.8×
Aetna623$120.12$382.07$1,0078.4×
Medicaid418$88.44$177.46$528.846.0×
correctional care [11003]310$126.99$159.56$224.771.8×
First Health510$171$439.5$762.754.5×
fallon mcaid carelon hlth [29]49$228$586$1,0174.5×
harvard pilgrim [10701]39$286.19$286.19$286.191.0×
Cigna49$25.35$445.5$715.7828.2×
grants [20507]49$228$586$1,0174.5×
connecticare [11105]49$228$586$1,0174.5×
commonwealth care mcr [10115]38$133.34$167.53$319.112.4×
Multiplan38$171$320.25$762.754.5×
evernorth behavioral health [27]37$182.4$214.4$805.64.4×
Medicare47$126.99$158.78$159.561.3×
masshealth mcd mbhp [38]37$228$268$1,0074.4×
tufts us family [11203]46$126.99$159.56$161.531.3×
CHAMPVA46$137.74$161.42$163.911.2×
wellfleet [11106]26$205.2$241.2$527.42.6×
automobile [10401]26$228$268$5862.6×
mgb mcr [10124]46$133.34$164.53$167.531.3×
tufts connectorcare [10507]46$216.01$271.41$274.771.3×
tufts [11201]46$23.04$37.71$715.7831.1×
senior whole health [10110]46$135.88$170.73$172.841.3×
wellsense cc carelon hlth [20]26$228$268$5862.6×
optum transplant [20601]26$228$268$5862.6×
geisinger15$141.05$362.56$734.185.2×
tufts dual [10111]35$126.99$159.56$159.561.3×
fallon mcr [10105]35$133.34$167.53$169.611.3×
workers compensation [20501]44$188.86$188.86$188.861.0×
devon health14$431.2$652.19$873.182.0×
eternalhealth mcr replace [10116]24$133.34$150.44$167.531.3×
fallon connectorcare [10503]24$58$167.88$277.764.8×
harvard pilgrim mcr supp [20203]24$133.34$150.44$167.531.3×
hsno/free care [10801]44$294.3$672.16$680.812.3×
tufts mcr supp [20209]24$133.34$150.44$167.531.3×
pennsylvania health and wellness13$146.93$170.85$345.982.4×
hp optum bh [32]23$934$1,007$1,0171.1×
wellpoint [11112]33$77.02$155.49$155.492.0×
fallon carelon hlth [28]23$934$1,007$1,0171.1×
qualcare inc12$621.31$641.94$662.571.1×
keystone first12$136.09$205.84$275.592.0×
hne [11108]22$264.29$264.29$264.291.0×
occunet12$154$232.93$311.852.0×
point comfort12$176$266.2$356.42.0×
fallon mcr supp [20202]22$167.53$168.57$169.611.0×
tufts mcr [10112]22$167.53$168.57$169.611.0×
amerihealth12$559.18$559.18$559.181.0×
fallon12$100$130.71$161.421.6×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
HARRINGTON MEMORIAL HOSPITALSOUTHBRIDGEMA27$1,007$1,007$153.04$523.64$1,007
BETH ISRAEL DEACONESS - PLYMOUTHPLYMOUTHMA9$809$168.51$120.34$463.8$755.03
HEALTHALLIANCE-CLINTONLEOMINSTERMA30$1,017$1,017$23.04$290.25$1,017
CHESTNUT HILL BENEVOLENT ASSOCIATIONCHESTNUT HILLMA14$891$42.24$222.75$873.18
UMASS MEMORIAL MEDICAL CENTERWORCESTERMA36$586$586$35.91$205.2$672.16
MARLBOROUGH HOSPITALMARLBOROUGHMA36$586$586$35.91$205.2$672.16
WHITTIER HOSPITAL-BRADFORDBRADFORDMA7$550$550$20$147.68$209.51
NORTH SHORE MEDICAL CENTERSALEMMA0$1,914.04$1,914.04
FAIRVIEW HOSPITALGREAT BARRINGTONMA0$1,188.98$1,129.53
NORTH ADAMS REGIONAL HOSPITALNORTH ADAMSMA0$1,188.98$1,129.53
HEBREW REHABILITATION CENTERROSLINDALEMA0$306.08$306.08
BERKSHIRE MEDICAL CENTERPITTSFIELDMA0$1,188.98$1,129.53

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.