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ED visit level 1

CPT 99281 · negotiated-rate distribution across hospitals in MA

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Hospitals
11
Min
$116.95
Median
$251.30
Max
$570.00
Range multiplier
4.9×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield732$86.63$187.00$2,958.0034.1×
UnitedHealthcare730$5.86$233.53$1,323.00225.8×
Aetna723$93.56$306.73$1,446.9015.5×
institution [10406]415$102.31$484.00$484.004.7×
Cigna714$90.10$370.65$1,177.8013.1×
harvard pilgrim [10701]412$242.00$671.50$840.003.5×
Medicaid49$84.76$159.72$251.683.0×
tufts [11201]46$115.86$799.11$878.997.6×
medcost16$169.64$257.32$405.752.4×
Multiplan45$351.75$363.00$569.701.6×
First Health55$122.25$363.00$631.205.2×
senior whole health [10110]44$108.13$108.80$109.471.0×
wellpoint [11112]44$150.70$150.70$150.701.0×
hne [11108]44$106.08$218.28$261.662.5×
hsno/free care [10801]44$294.30$672.16$680.812.3×
connecticare [11105]44$163.00$476.50$484.003.0×
correctional care [11003]34$102.31$534.16$966.009.4×
grants [20507]44$163.00$476.50$484.003.0×
amerihealth24$91.79$720.74$1,504.0016.4×
Humana34$89.23$343.74$601.356.7×
fallon connectorcare [10503]44$178.75$204.09$229.421.3×
fallon mcaid carelon hlth [29]44$163.00$476.50$484.003.0×
workers compensation [20501]44$79.51$173.88$193.602.4×
Medicare33$101.06$101.06$102.311.0×
upmc health plan13$90.96$318.00$318.003.5×
masshealth mcd mbhp [38]33$163.00$484.00$484.003.0×
tufts us family [11203]33$101.06$101.06$102.311.0×
evernorth behavioral health [27]33$130.40$387.20$387.203.0×
geisinger13$51.00$90.10$602.8211.8×
pennsylvania health and wellness13$50.00$90.96$160.273.2×
fallon carelon hlth [28]22$163.00$316.00$469.002.9×
automobile [10401]22$484.00$484.00$484.001.0×
devon health12$1,558.20$1,558.20$1,558.201.0×
directnet12$374.10$374.10$374.101.0×
fidelis care12$98.79$185.94$273.092.8×
health partners plans12$55.00$72.98$90.961.7×
keystone first12$88.36$199.18$310.003.5×
optum transplant [20601]22$484.00$484.00$484.001.0×
oscar12$189.90$221.55$253.201.3×
private healthcare systems12$519.06$519.06$519.061.0×
qualcare inc12$861.58$1,124.29$1,387.001.6×
WellCare22$92.73$144.66$196.592.1×
wellfleet [11106]22$435.60$435.60$435.601.0×
wellpoint12$98.79$359.40$620.006.3×
wellsense cc carelon hlth [20]22$484.00$484.00$484.001.0×
harvard pilgrim mcr [10106]11$107.42$107.42$107.421.0×
point comfort11$86.63$86.63$86.631.0×
alliance11$93.62$93.62$93.621.0×
wellsense mcaid carelon hlth [21]11$163.00$163.00$163.001.0×
gateway health plan11$90.96$90.96$90.961.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Beth Israel Deaconess - PlymouthPlymouthMA13$1,052.00$219.13$5.86$570.00$2,958.00
Marlborough HospitalMarlboroughMA28$484.00$484.00$101.06$411.40$1,177.80
Umass Memorial Medical CenterWorcesterMA28$484.00$484.00$101.06$411.40$1,177.80
High Point HospitalMiddleboroughMA19$633.00$316.50$91.79$251.30$1,323.00
Healthalliance-ClintonLeominsterMA24$469.00$469.00$102.31$246.23$643.00
Harrington Memorial HospitalSouthbridgeMA23$163.00$163.00$79.51$138.42$680.81
Chestnut Hill Benevolent AssociationChestnut HillMA19$1,590.00$50.00$116.95$1,558.20
North Adams Regional HospitalNorth AdamsMA0$220.05$209.05
Berkshire Medical CenterPittsfieldMA0$220.05$209.05
North Shore Medical CenterSalemMA0$886.17$886.17
Fairview HospitalGreat BarringtonMA0$220.05$209.05

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.