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Emergency Department Visit with High Level of Medical Decision Making Cost in Massachusetts
What this costs without insurance: real self-pay cash prices and insurance-negotiated rates at 38 Massachusetts hospitals. CPT 99285. Sourced directly from each facility's CMS-mandated transparency file. Dataset: Q4 2026.
📊 Median $1,122
📉 Low $378
📈 High $5,376
🏥 38 hospitals
🏛️ 12 with insurance contracts
🇺🇸 Medicare $175
Hospital comparison — Massachusetts
Sorted by cash price (lowest first). Showing top 38 of 38 hospitals.
Billed more than $1,122 for this? That gap is evidence.
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| Hospital | Cash | Aetna | BCBS | UHC | Cigna | MultiPlan | Health Net | Humana | Centene |
|---|---|---|---|---|---|---|---|---|---|
| NANTUCKET COTTAGE HOSPITAL NANTUCKET |
$378 | — | — | — | — | — | — | — | — |
| STURDY MEMORIAL HOSPITAL ATTLEBORO |
$389 | $85.00 | $70.67 | $69.03 | $90.00 | — | — | — | $714 |
| HOLYOKE MEDICAL CENTER HOLYOKE |
$402 | — | — | — | — | — | — | — | — |
| MERCY MEDICAL CENTER - SPRINGFIELD SPRINGFIELD |
$428 | — | — | — | — | — | — | — | — |
| BAYSTATE FRANKLIN MEDICAL CENTER GREENFIELD |
$661 | — | — | — | — | — | — | — | — |
| BOSTON MEDICAL CENTER - SOUTH BROCKTON |
$755 | — | — | — | — | — | — | — | — |
| HEYWOOD HOSPITAL GARDNER |
$759 | $701 | $946 | $1,962 | $921 | — | — | — | — |
| MARTHA'S VINEYARD HOSPITAL OAK BLUFFS |
$792 | — | — | — | — | — | — | — | — |
| BOSTON MEDICAL CENTER - BRIGHTON BRIGHTON |
$868 | — | — | — | — | — | — | — | — |
| MASSACHUSETTS EYE AND EAR INFIRMARY BOSTON |
$892 | — | — | — | — | — | — | — | — |
| ATHOL HOSPITAL ATHOL |
$948 | $882 | $802 | $1,962 | $1,283 | — | — | — | — |
| MELROSE WAKEFIELD HOSPITAL MELROSE |
$992 | — | — | — | — | — | — | — | — |
| FALMOUTH HOSPITAL FALMOUTH |
$1,011 | $95.00 | $83.00 | $80.12 | $90.93 | $95.00 | — | — | — |
| CAPE COD HOSPITAL HYANNIS |
$1,011 | $95.00 | $80.71 | $79.32 | $81.75 | $95.00 | — | — | — |
| UMASS MEMORIAL HOSPITAL - HARRINGTON HOSPITAL SOUTH ST SOUTHBRIDGE |
$1,083 | — | — | — | — | — | — | — | — |
| TOBEY HOSPITAL WAREHAM |
$1,090 | — | — | — | — | — | — | — | — |
| ST. LUKE'S HOSPITAL NEW BEDFORD |
$1,090 | — | — | — | — | — | — | — | — |
| CHARLTON MEMORIAL HOSPITAL FALL RIVER |
$1,090 | — | — | — | — | — | — | — | — |
| BOSTON MEDICAL CENTER BOSTON |
$1,122 | — | — | — | — | — | — | — | — |
| COOLEY DICKINSON HOSPITAL NORTHAMPTON |
$1,198 | — | — | — | — | — | — | — | — |
| SOUTH SHORE HOSPITAL SOUTH WEYMOUTH |
$1,263 | $714 | $601 | — | — | — | — | — | — |
| MILFORD REGIONAL MEDICAL CENTER MILFORD |
$1,296 | $80.40 | $638 | $81.00 | $927 | — | — | — | — |
| LOWELL GENERAL - SAINTS CAMPUS LOWELL |
$1,568 | — | — | — | — | — | — | — | — |
| SIGNATURE HEALTHCARE BROCKTON HOSPITAL BROCKTON |
$1,619 | $1,242 | $941 | $1,505 | $1,010 | — | — | $728 | — |
| TUFTS MEDICAL CENTER BOSTON |
$1,642 | — | — | — | — | — | — | — | — |
| UMASS MEMORIAL HEALTH ALLIANCE - CLINTON HOSPITAL HOSPITAL RD. LEOMINSTER |
$2,135 | — | — | — | — | — | — | — | — |
| PAM HEALTH SPECIALTY HOSPITAL OF STOUGHTON SUMNER STREET STOUGHTON |
$2,452 | — | — | — | — | — | — | — | — |
| NEWTON WELLESLEY HOSPITAL NEWTON |
$2,527 | — | — | — | — | — | — | — | — |
| MASS GENERAL BRIGHAM SALEM HOSPITAL SALEM |
$2,527 | — | — | — | — | — | — | — | — |
| BRIGHAM AND WOMEN'S FAULKNER HOSPITAL BOSTON |
$2,527 | — | — | — | — | — | — | — | — |
| MASSACHUSETTS GENERAL HOSPITAL BOSTON |
$2,768 | — | — | — | — | — | — | — | — |
| BRIGHAM AND WOMEN'S HOSPITAL BOSTON |
$2,768 | — | — | — | — | — | — | — | — |
| CHA CAMBRIDGE HOSPITAL CAMBRIDGE |
$3,000 | — | — | — | — | — | — | — | — |
| BOSTON CHILDREN'S HOSPITAL BOSTON |
$3,012 | $1,807 | $1,699 | $1,801 | $1,443 | $2,771 | — | $2,711 | $1,904 |
| ST VINCENT HOSPITAL WORCESTER |
$3,682 | — | — | — | — | — | $168 | — | — |
| UMASS MEMORIAL MEDICAL CENTER - MARLBOROUGH CAMPUS BELMONT STREET WORCESTER |
$4,226 | — | — | — | — | — | — | — | — |
| FRAMINGHAM UNION HOSPITAL FRAMINGHAM |
$5,376 | — | — | — | — | — | $168 | — | — |
| LEONARD MORSE HOSPITAL NATICK |
$5,376 | — | — | — | — | — | $168 | — | — |
What these prices are. Each figure is the facility’s own published self-pay (cash) price for CPT 99285, filed under the federal price transparency rule (45 CFR Part 180). Hospital facility charges may not include separate physician, anesthesia, or pathology fees. National median for this code: $1,180 across all reporting facilities. Dataset: Q4 2026. Always confirm the final price with the facility before booking.
Billed more than $1,122 for this?
That is the median of what the 38 Massachusetts hospitals above publish for Emergency department visit with high level of medical decision making — their own figures, filed under federal law. A bill well above them is evidence you can put in writing.
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Medicare reimbursement benchmark
For CPT 99285 in Massachusetts, Medicare reimburses about $175 on the 2026 Physician Fee Schedule (non-facility, state average across localities). Hospital cash prices for the same code in Massachusetts range from $378 to $5,376 — that means hospital cash prices are typically 6.4x what Medicare pays. If a self-pay quote you receive is more than 2-3x the Medicare rate, ask the hospital for the cash-discount price in writing.
Frequently asked questions
- How much does emergency department visit with high level of medical decision making cost in Massachusetts?
- Cash prices for emergency department visit with high level of medical decision making (CPT 99285) in Massachusetts range from $378 to $5,376, with a median of $1,122. Prices vary widely by hospital.
- Where can I find the cheapest emergency department visit with high level of medical decision making in Massachusetts?
- The cheapest Massachusetts hospital published cash price for this procedure is $378. Use the table above sorted by cash price to find the lowest-priced facility near you.
- Are these the prices I'll pay?
- These are the rates hospitals publish. Final price depends on your insurance, deductible, and the specific services billed. Always confirm with the facility and your insurer before any procedure.
- Why do prices vary so much between hospitals?
- Hospitals set cash prices independently, and insurance contracts negotiate different rates per payer. Two facilities a few miles apart can charge 5-10x different prices for the same procedure.
- Where does this data come from?
- Federal law (45 CFR § 180) requires hospitals to publish their pricing in a machine-readable file. We aggregate these files and republish in a consumer-friendly format.
Emergency department visit with high level of medical decision making in nearby states
Other procedures in Massachusetts
Methodology. Cash prices and insurance-negotiated rates published by each Massachusetts facility under federal price transparency rules (45 CFR § 180). CPT code 99285 (Doctor Visits). Data refreshed regularly; verify with the facility before any procedure.