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Office visit, established patient, 20-29 minutes

CPT 99213 · negotiated-rate distribution across hospitals in MA

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Hospitals
13
Min
$78.35
Median
$149.00
Max
$294.10
Range multiplier
3.8×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare755$45.83$124.49$419.509.2×
Blue Cross Blue Shield755$13.82$133.49$478.7834.6×
institution [10406]450$58.12$160.55$258.004.4×
Aetna732$39.31$168.92$494.0012.6×
Medicaid419$49.17$118.56$256.885.2×
Cigna413$25.35$259.50$395.8815.6×
harvard pilgrim [10701]412$118.02$118.02$118.021.0×
First Health511$111.75$193.50$370.503.3×
grants [20507]410$149.00$258.00$494.003.3×
connecticare [11105]410$149.00$258.00$494.003.3×
fallon mcaid carelon hlth [29]410$149.00$258.00$494.003.3×
correctional care [11003]310$58.12$159.56$161.532.8×
Multiplan38$111.75$182.25$363.003.2×
masshealth mcd mbhp [38]38$149.00$243.00$494.003.3×
evernorth behavioral health [27]38$119.20$194.40$395.203.3×
CHAMPVA47$58.12$137.74$163.912.8×
tufts connectorcare [10507]47$98.86$271.41$274.772.8×
geisinger17$42.00$212.00$427.6610.2×
tufts [11201]47$23.04$39.51$351.1415.2×
mgb mcr [10124]47$61.03$161.53$169.612.8×
wellsense cc carelon hlth [20]26$149.00$228.00$258.001.7×
Medicare46$58.12$159.17$161.532.8×
devon health16$141.12$490.00$508.623.6×
wellfleet [11106]26$134.10$205.20$232.201.7×
automobile [10401]26$149.00$228.00$258.001.7×
fallon mcr [10105]36$61.03$167.53$169.612.8×
tufts us family [11203]46$58.12$159.56$161.532.8×
senior whole health [10110]46$62.19$170.73$172.842.8×
optum transplant [20601]26$149.00$228.00$258.001.7×
tufts dual [10111]35$58.12$159.56$161.532.8×
commonwealth care mcr [10115]35$61.03$167.53$169.612.8×
workers compensation [20501]44$65.91$65.91$65.911.0×
eternalhealth mcr replace [10116]24$61.03$114.28$167.532.7×
fallon carelon hlth [28]24$403.00$464.00$494.001.2×
fallon connectorcare [10503]24$58.00$90.15$122.292.1×
harvard pilgrim mcr supp [20203]24$61.03$114.28$167.532.7×
hp optum bh [32]24$403.00$464.00$494.001.2×
hsno/free care [10801]44$294.30$672.16$680.812.3×
pennsylvania health and wellness14$43.75$125.04$201.534.6×
tufts mcr supp [20209]24$61.03$114.28$167.532.7×
wellpoint [11112]44$42.29$75.93$109.562.6×
innovage13$36.00$125.00$129.753.6×
point comfort13$57.60$200.00$207.603.6×
hne [11108]33$116.36$116.36$262.272.3×
fallon mcr supp [20202]23$167.53$169.61$169.611.0×
keystone first13$44.54$154.65$160.533.6×
occunet13$50.40$175.00$181.653.6×
eternal health12$58.12$108.45$158.782.7×
commonwealth care alliance [10103]12$167.53$168.57$169.611.0×
wellsense mcaid carelon hlth [21]12$403.00$448.50$494.001.2×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Whittier Hospital-BradfordBradfordMA6$550.00$550.00$20.00$78.35$158.78
Beth Israel Deaconess - PlymouthPlymouthMA9$513.00$106.85$49.80$294.10$478.78
Harrington Memorial HospitalSouthbridgeMA30$494.00$494.00$42.29$271.41$680.81
Healthalliance-ClintonLeominsterMA30$484.00$484.00$23.04$172.84$484.00
Umass Memorial Medical CenterWorcesterMA36$258.00$258.00$35.91$149.00$672.16
Marlborough HospitalMarlboroughMA36$258.00$258.00$35.91$149.00$672.16
Chestnut Hill Benevolent AssociationChestnut HillMA14$519.00$13.82$128.60$508.62
Whittier Hospital-WestboroughWestboroughMA1$550.00$550.00$58.12$108.45$158.78
Fairview HospitalGreat BarringtonMA0$418.71$397.77
Berkshire Medical CenterPittsfieldMA0$418.71$397.77
Hebrew Rehabilitation CenterRoslindaleMA0$108.33$108.33
North Shore Medical CenterSalemMA0$1,342.88$1,342.88
North Adams Regional HospitalNorth AdamsMA0$418.71$397.77

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.