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ED visit level 4

CPT 99284 · negotiated-rate distribution across hospitals in MA

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Hospitals
11
Min
$456.54
Median
$1,187.18
Max
$1,485
Range multiplier
3.3×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare736$64.27$665.6$3,10348.3×
Blue Cross Blue Shield736$428.68$756$3,5028.2×
Aetna727$462.97$1,472.24$5,448.1711.8×
institution [10406]420$500.07$2,679.03$3,5027.0×
Cigna715$445.83$1,151$5,775.3913.0×
harvard pilgrim [10701]412$242$671.5$8403.5×
Medicaid49$478.92$950.56$1,821.043.8×
correctional care [11003]38$500.07$503.17$2,4174.8×
tufts [11201]46$654.65$1,564.4$1,720.782.6×
medcost16$937.2$1,421.53$2,241.582.4×
First Health55$690.75$1,879.8$2,626.53.8×
Multiplan45$1,371$2,626.5$3,147.32.3×
wellpoint [11112]44$457.73$457.73$457.731.0×
fallon connectorcare [10503]44$929.5$1,294.73$1,659.951.8×
fallon mcaid carelon hlth [29]44$115.92$2,665$3,50230.2×
amerihealth24$507.07$1,811.57$3,0346.0×
Humana34$441.54$1,864.98$3,322.157.5×
grants [20507]44$921$2,665$3,5023.8×
hsno/free care [10801]44$294.3$672.16$680.812.3×
hne [11108]44$599.39$1,299.62$1,579.42.6×
CHAMPVA44$455.12$523.64$541.591.2×
tufts us family [11203]44$500.07$503.17$506.261.0×
tufts connectorcare [10507]44$850.61$850.61$850.611.0×
workers compensation [20501]44$449.26$1,000.83$1,400.83.1×
connecticare [11105]44$921$2,665$3,5023.8×
devon health14$2,064.86$3,966.06$5,867.262.8×
senior whole health [10110]44$535.07$538.38$541.691.0×
mgb mcr [10124]44$500.07$525.07$525.071.0×
upmc health plan13$133.46$190.66$450.113.4×
commonwealth care mcr [10115]33$525.07$525.07$525.071.0×
evernorth behavioral health [27]33$736.8$2,801.6$2,801.63.8×
fallon mcr [10105]33$525.07$525.07$525.071.0×
geisinger13$239$445.83$1,2245.1×
masshealth mcd mbhp [38]33$921$3,502$3,5023.8×
Medicare33$500.07$500.07$506.261.0×
pennsylvania health and wellness13$245$450.11$793.063.2×
tufts dual [10111]33$500.07$500.07$500.071.0×
keystone first12$310$373.63$437.251.4×
fidelis care12$477.74$645.53$813.321.7×
fallon mcr supp [20202]22$525.07$525.07$525.071.0×
directnet12$2,066.73$2,066.73$2,066.731.0×
optum transplant [20601]22$3,502$3,502$3,5021.0×
oscar12$1,049.1$1,223.95$1,398.81.3×
tufts mcr [10112]22$525.07$525.07$525.071.0×
tufts mcr supp [20209]22$525.07$525.07$525.071.0×
fallon carelon hlth [28]22$921$1,374.5$1,8282.0×
wellsense cc carelon hlth [20]22$3,502$3,502$3,5021.0×
automobile [10401]22$3,502$3,502$3,5021.0×
eternalhealth mcr replace [10116]22$525.07$525.07$525.071.0×
private healthcare systems12$2,867.54$2,867.54$2,867.541.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
HEALTHALLIANCE-CLINTONLEOMINSTERMA32$1,828$1,828$294.3$600.86$1,828
HARRINGTON MEMORIAL HOSPITALSOUTHBRIDGEMA31$921$921$115.92$541.69$5,775.39
CHESTNUT HILL BENEVOLENT ASSOCIATIONCHESTNUT HILLMA19$5,987$133.46$456.54$5,867.26
BETH ISRAEL DEACONESS - PLYMOUTHPLYMOUTHMA13$3,133$652.6$64.27$1,485$3,034
HIGH POINT HOSPITALMIDDLEBOROUGHMA19$3,497$1,748.5$507.07$1,388.31$3,322.15
MARLBOROUGH HOSPITALMARLBOROUGHMA37$3,502$3,502$457.73$1,187.18$3,502
UMASS MEMORIAL MEDICAL CENTERWORCESTERMA37$3,502$3,502$457.73$1,187.18$3,502
NORTH ADAMS REGIONAL HOSPITALNORTH ADAMSMA0$1,737.16$1,650.3
FAIRVIEW HOSPITALGREAT BARRINGTONMA0$1,737.16$1,650.3
BERKSHIRE MEDICAL CENTERPITTSFIELDMA0$1,737.16$1,650.3
NORTH SHORE MEDICAL CENTERSALEMMA0$5,545.92$5,545.92

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.