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Office visit, established patient, 30-39 minutes

CPT 99214 · negotiated-rate distribution across hospitals in MA

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Hospitals
12
Min
$108.23
Median
$167.53
Max
$323.34
Range multiplier
3.0×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare764$65.43$145.21$3936.0×
Blue Cross Blue Shield759$20$164.85$1,261.2663.1×
institution [10406]453$85.41$193$363.584.3×
Aetna737$58.97$171$651.5611.0×
Medicaid420$63.69$117.2$356.725.6×
Cigna518$25.35$160.55$435.2317.2×
First Health512$128.25$217.13$514.54.0×
tufts [11201]412$23.04$53.87$315.613.7×
harvard pilgrim [10701]412$166.44$166.44$166.441.0×
grants [20507]411$171$228$6864.0×
connecticare [11105]411$171$228$6864.0×
fallon mcaid carelon hlth [29]411$171$228$6864.0×
correctional care [11003]310$85.41$159.56$161.531.9×
mgb mcr [10124]49$89.68$161.53$169.611.9×
masshealth mcd mbhp [38]39$171$228$4442.6×
evernorth behavioral health [27]39$136.8$182.4$355.22.6×
tufts connectorcare [10507]49$145.28$271.41$274.771.9×
Multiplan38$144.75$217.13$514.53.6×
Medicare48$72.6$159.17$161.532.2×
fallon connectorcare [10503]28$58$151.8$249.564.3×
CHAMPVA47$85.41$137.74$163.911.9×
tufts us family [11203]47$85.41$159.56$161.531.9×
fallon mcr [10105]37$89.68$167.53$169.611.9×
geisinger17$65.3$228.54$589.989.0×
senior whole health [10110]47$91.39$170.73$172.841.9×
commonwealth care mcr [10115]36$89.68$167.53$323.063.6×
devon health16$211.68$528.22$701.683.3×
wellfleet [11106]26$173.7$205.2$315.91.8×
optum transplant [20601]26$193$228$3511.8×
tufts dual [10111]36$85.41$159.56$161.531.9×
automobile [10401]26$193$228$3511.8×
wellsense cc carelon hlth [20]26$193$228$3511.8×
tufts mcr [10112]25$100.29$167.53$169.611.7×
fallon mcr supp [20202]25$100.29$167.53$169.611.7×
hp optum bh [32]25$171$444$6864.0×
fallon carelon hlth [28]25$171$444$6864.0×
workers compensation [20501]44$98.77$98.77$98.771.0×
eternalhealth mcr replace [10116]24$89.68$128.61$167.531.9×
harvard pilgrim mcr supp [20203]24$89.68$128.61$167.531.9×
hsno/free care [10801]44$294.3$672.16$680.812.3×
pennsylvania health and wellness14$68.03$146.58$278.024.1×
tufts mcr supp [20209]24$89.68$128.61$167.531.9×
wellpoint [11112]44$58.25$106.87$155.492.7×
occunet13$75.6$188.65$250.63.3×
commonwealth care alliance [10103]13$100.29$167.53$169.611.7×
tufts13$88.87$114.64$158.781.8×
hne [11108]33$158.3$158.3$288.961.8×
keystone first13$66.81$166.71$221.463.3×
innovage13$54$134.75$1793.3×
point comfort13$86.4$215.6$286.43.3×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
BETH ISRAEL DEACONESS - PLYMOUTHPLYMOUTHMA9$564$117.48$70.14$323.34$526.38
HEALTHALLIANCE-CLINTONLEOMINSTERMA30$686$686$23.04$169.61$686
HARRINGTON MEMORIAL HOSPITALSOUTHBRIDGEMA30$444$444$58.25$168.57$680.81
MARLBOROUGH HOSPITALMARLBOROUGHMA36$351$351$35.91$167.53$672.16
UMASS MEMORIAL MEDICAL CENTERWORCESTERMA36$351$351$35.91$167.53$672.16
CHESTNUT HILL BENEVOLENT ASSOCIATIONCHESTNUT HILLMA14$716$20.74$160.27$1,261.26
WHITTIER HOSPITAL-BRADFORDBRADFORDMA14$550$550$20$108.23$158.78
NORTH ADAMS REGIONAL HOSPITALNORTH ADAMSMA0$669.95$636.45
FAIRVIEW HOSPITALGREAT BARRINGTONMA0$669.95$636.45
BERKSHIRE MEDICAL CENTERPITTSFIELDMA0$669.95$636.45
HEBREW REHABILITATION CENTERROSLINDALEMA0$159.24$159.24
NORTH SHORE MEDICAL CENTERSALEMMA0$1,490.03$1,490.03

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.