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Office visit, established patient, 10-19 min

CPT 99212 · negotiated-rate distribution across hospitals in MA

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Hospitals
11
Min
$30.25
Median
$166.89
Max
$266.58
Range multiplier
8.8×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield663$3.17$49.06$433.98136.9×
UnitedHealthcare653$31.14$90.51$293.829.4×
institution [10406]450$31.33$159.56$228.007.3×
Aetna634$9.01$112.14$436.8048.5×
Medicaid419$38.28$89.44$179.924.7×
Cigna414$16.50$161.53$358.8421.7×
harvard pilgrim [10701]412$73.49$73.49$73.491.0×
First Health511$73.50$171.00$279.003.8×
grants [20507]410$98.00$200.00$346.003.5×
connecticare [11105]410$98.00$200.00$346.003.5×
correctional care [11003]310$31.33$159.56$161.535.2×
fallon mcaid carelon hlth [29]410$98.00$200.00$346.003.5×
geisinger19$13.99$31.20$395.5228.3×
evernorth behavioral health [27]38$78.40$137.60$276.803.5×
devon health18$32.34$55.37$470.4014.5×
Multiplan38$87.00$150.00$218.252.5×
masshealth mcd mbhp [38]38$98.00$172.00$346.003.5×
commonwealth care mcr [10115]37$32.90$167.53$319.119.7×
CHAMPVA47$31.33$137.74$163.915.2×
mgb mcr [10124]47$32.90$161.53$169.615.2×
tufts [11201]47$23.04$39.51$245.9410.7×
tufts connectorcare [10507]47$53.29$271.41$274.775.2×
wellsense cc carelon hlth [20]26$116.00$172.00$228.002.0×
wellfleet [11106]26$104.40$154.80$205.202.0×
tufts us family [11203]46$31.33$159.56$161.535.2×
senior whole health [10110]46$33.52$170.73$172.845.2×
fallon mcr [10105]36$32.90$167.53$169.615.2×
optum transplant [20601]26$116.00$172.00$228.002.0×
automobile [10401]26$116.00$172.00$228.002.0×
pennsylvania health and wellness15$12.81$22.91$186.3814.5×
Medicare35$31.33$159.56$161.535.2×
tufts dual [10111]35$31.33$159.56$161.535.2×
fallon carelon hlth [28]24$98.00$279.00$346.003.5×
eternalhealth mcr replace [10116]24$32.90$100.22$167.535.1×
hsno/free care [10801]44$294.30$672.16$680.812.3×
hp optum bh [32]24$98.00$279.00$346.003.5×
occunet14$11.55$19.78$168.0014.5×
point comfort14$13.20$22.60$192.0014.5×
harvard pilgrim mcr supp [20203]24$32.90$100.22$167.535.1×
workers compensation [20501]44$41.58$41.58$41.581.0×
tufts mcr supp [20209]24$32.90$100.22$167.535.1×
fallon connectorcare [10503]24$58.00$69.77$81.531.4×
wellpoint [11112]44$35.73$68.11$100.492.8×
innovage14$8.25$14.13$120.0014.5×
keystone first14$10.21$17.48$148.4614.5×
tufts mcr [10112]23$167.53$169.61$169.611.0×
fallon mcr supp [20202]23$167.53$169.61$169.611.0×
hne [11108]33$77.57$77.57$225.182.9×
upmc health plan12$36.40$44.20$52.001.4×
wellsense mcaid carelon hlth [21]12$98.00$222.00$346.003.5×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Chestnut Hill Benevolent AssociationChestnut HillMA14$480.00$3.17$30.25$470.40
Beth Israel Deaconess - PlymouthPlymouthMA9$465.00$96.85$31.14$266.58$433.98
Harrington Memorial HospitalSouthbridgeMA30$346.00$346.00$34.61$167.21$680.81
Healthalliance-ClintonLeominsterMA30$291.00$291.00$23.04$166.89$294.30
Umass Memorial Medical CenterWorcesterMA36$228.00$228.00$31.33$116.00$672.16
Marlborough HospitalMarlboroughMA36$228.00$228.00$31.33$116.00$672.16
Whittier Hospital-BradfordBradfordMA0$550.00$550.00
North Shore Medical CenterSalemMA0$892.71$892.71
Berkshire Medical CenterPittsfieldMA0$296.81$281.97
North Adams Regional HospitalNorth AdamsMA0$296.81$281.97
Fairview HospitalGreat BarringtonMA0$296.81$281.97

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.