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ED visit level 5

CPT 99285 · negotiated-rate distribution across hospitals in MA

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Hospitals
11
Min
$639.36
Median
$1,432.61
Max
$1,970.71
Range multiplier
3.1×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield736$554$996.72$4,259.587.7×
UnitedHealthcare736$93.07$841.68$3,31235.6×
Aetna725$660.78$2,020.35$9,765.2114.8×
institution [10406]420$713.71$3,232.89$4,2265.9×
Cigna715$636.3$1,355.6$5,775.399.1×
harvard pilgrim [10701]412$242$671.5$8403.5×
Medicaid49$563.16$1,110.2$2,197.523.9×
correctional care [11003]38$713.71$713.71$2,4173.4×
medcost16$1,330.35$2,017.87$3,181.922.4×
tufts [11201]46$769.8$1,981.96$2,180.082.8×
First Health55$812.25$2,738.4$3,169.53.9×
Multiplan45$1,601.25$3,169.5$4,467.62.8×
connecticare [11105]44$1,083$3,180.5$4,2263.9×
tufts connectorcare [10507]44$1,214.03$1,214.03$1,214.031.0×
tufts us family [11203]44$713.71$718.13$722.551.0×
senior whole health [10110]44$763.67$763.67$763.671.0×
hsno/free care [10801]44$294.3$672.16$680.812.3×
mgb mcr [10124]44$713.71$749.4$749.41.1×
CHAMPVA44$655.28$753.94$779.791.2×
wellpoint [11112]44$457.73$457.73$457.731.0×
hne [11108]44$704.82$1,548.53$1,905.932.7×
fallon connectorcare [10503]44$1,251.25$1,627.19$2,003.121.6×
fallon mcaid carelon hlth [29]44$171.45$3,180.5$4,22624.6×
amerihealth24$719.78$2,194.16$3,3874.7×
grants [20507]44$1,083$3,180.5$4,2263.9×
Humana34$630.18$2,652.19$4,715.87.5×
workers compensation [20501]44$528.29$1,196.09$1,690.43.2×
upmc health plan13$194.24$277.48$642.423.3×
commonwealth care mcr [10115]33$749.4$749.4$749.41.0×
evernorth behavioral health [27]33$866.4$3,380.8$3,380.83.9×
fallon mcr [10105]33$749.4$749.4$749.41.0×
geisinger13$302$636.3$1,7345.7×
masshealth mcd mbhp [38]33$1,083$4,226$4,2263.9×
Medicare33$713.71$713.71$722.551.0×
pennsylvania health and wellness13$375$642.42$1,131.893.0×
tufts dual [10111]33$713.71$713.71$713.711.0×
hp optum bh [32]22$1,083$1,609$2,1352.0×
fidelis care12$687.85$936.33$1,184.811.7×
fallon mcr supp [20202]22$749.4$749.4$749.41.0×
keystone first12$310$467.04$624.072.0×
fallon carelon hlth [28]22$1,083$1,609$2,1352.0×
eternalhealth mcr replace [10116]22$749.4$749.4$749.41.0×
wellsense cc carelon hlth [20]22$4,226$4,226$4,2261.0×
optum transplant [20601]22$4,226$4,226$4,2261.0×
oscar12$1,489.2$1,737.4$1,985.61.3×
private healthcare systems12$4,070.48$4,070.48$4,070.481.0×
qualcare inc12$1,387$2,562.46$3,737.912.7×
directnet12$2,933.72$2,933.72$2,933.721.0×
devon health12$10,516$10,516$10,5161.0×
tufts mcr [10112]22$749.4$749.4$749.41.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
HARRINGTON MEMORIAL HOSPITALSOUTHBRIDGEMA31$1,083$1,083$171.45$749.4$5,775.39
HEALTHALLIANCE-CLINTONLEOMINSTERMA32$2,135$2,135$294.3$749.4$2,135
CHESTNUT HILL BENEVOLENT ASSOCIATIONCHESTNUT HILLMA19$10,731$194.24$639.36$10,516
HIGH POINT HOSPITALMIDDLEBOROUGHMA19$4,964$2,482$719.78$1,970.71$4,715.8
BETH ISRAEL DEACONESS - PLYMOUTHPLYMOUTHMA13$4,564$950.68$93.07$1,485$4,259.58
UMASS MEMORIAL MEDICAL CENTERWORCESTERMA37$4,226$4,226$457.73$1,432.61$4,226
MARLBOROUGH HOSPITALMARLBOROUGHMA37$4,226$4,226$457.73$1,432.61$4,226
NORTH SHORE MEDICAL CENTERSALEMMA0$7,149.31$7,149.31
FAIRVIEW HOSPITALGREAT BARRINGTONMA0$2,687$2,552.65
BERKSHIRE MEDICAL CENTERPITTSFIELDMA0$2,687$2,552.65
NORTH ADAMS REGIONAL HOSPITALNORTH ADAMSMA0$2,687$2,552.65

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.