Does The Shriners' Hospital for Children - Boston have an emergency room?

Medicare (CMS) data does not list emergency services at The Shriners' Hospital for Children - Boston. The closest hospitals that do: Massachusetts General Hospital (0.2 mi), Massachusetts Eye and Ear Infirmary - (0.2 mi) and Tufts Medical Center (0.9 mi). In a medical emergency, call 911.

Where is The Shriners' Hospital for Children - Boston?

51 Blossom Street, Boston, MA 02114, in Suffolk County, Massachusetts.

What is the phone number of The Shriners' Hospital for Children - Boston?

(617) 722-3000, as listed by Medicare (CMS).

What is the Medicare star rating of The Shriners' Hospital for Children - Boston?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

The Shriners' Hospital for Children - Boston

Quick answers

Does The Shriners' Hospital for Children - Boston have an emergency room?: Medicare (CMS) data does not list emergency services at The Shriners' Hospital for Children - Boston. The closest hospitals that do: Massachusetts General Hospital (0.2 mi), Massachusetts Eye and Ear Infirmary - (0.2 mi) and Tufts Medical Center (0.9 mi). In a medical emergency, call 911.
Where is The Shriners' Hospital for Children - Boston?: 51 Blossom Street, Boston, MA 02114, in Suffolk County, Massachusetts.
What is the phone number of The Shriners' Hospital for Children - Boston?: (617) 722-3000, as listed by Medicare (CMS).
What is the Medicare star rating of The Shriners' Hospital for Children - Boston?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4][10][14]

Conditions treated^{[9][10][11][14]}

Burn injuries
Cleft lip and palate
Craniofacial conditions
Complex skin conditions
Blistering skin conditions
Frostbite

Treatments^[10][14]

Cleft lip and palate surgical repair
Reconstructive surgery
Laser surgery on skin conditions
Pediatric rehabilitation and therapy

Procedures^[10]

Plastic surgery for ear and hand deformities

Programs and centers^[4][7]

Arthur C. Luf Children's Burn Camp
Fezzy Goes to School
Makeup Clinic
Music therapy
Patient and Family Advisory Council (PFAC)
Pet therapy
School Re-entry Program
Survivors Offering Assistance in Recovery (SOAR)
Team Brave Community Reintegration Program
Recreational therapy

Visiting and practical information

Visiting	Check in at lobby reception for a badge; up to four visitors at a time on the inpatient unit (siblings excepted); flu-season limits Oct 1-Mar 31^[5]
Parking	Visitor parking 24 hours a day in the hospital's garage directly underneath; entrance on Blossom Street^[8][6]
Interpreters and languages	Interpreter services by request at no cost, in person, video, phone or telehealth; in-house staff vary by location^[12]

Recognition^[9][10][11]

Verified pediatric burn center, American Burn Association
Certified by the American College of Surgeons
Cleft and Craniofacial Center accredited by the American Cleft Palate-Craniofacial Association

Nearest emergency rooms

Hospitals that list emergency services, by straight-line distance (not driving distance).

Massachusetts General Hospital0.2 mi · Boston, MA · Acute Care Hospital
Massachusetts Eye and Ear Infirmary -0.2 mi · Boston, MA · Acute Care Hospital
Tufts Medical Center0.9 mi · Boston, MA · Acute Care Hospital
Boston Medical Center2.0 mi · Boston, MA · Acute Care Hospital
Cambridge Health Alliance2.0 mi · Cambridge, MA · Acute Care Hospital

Other hospitals nearby

Spaulding Rehabilitation Hospital1.3 mi · Charlestown, MA · Inpatient Rehabilitation Hospital
Dr Solomon Carter Fuller Mental Health Center1.8 mi · Boston, MA · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

Boston Eye Surgery and Laser Center, Inc0.1 mi · Boston, MA
Shields Surgery Center4.7 mi · Medford, MA
Dha Endoscopy LLC7.9 mi · Stoneham, MA

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

McInnis Health Group0.1 mi · Boston, MA · Community health center
Massachusetts General Hospital0.1 mi · Boston, MA · Community health center
Lindemann Mental Health Center0.2 mi · Boston, MA · Community health center

Clinics and urgent care

Massachusetts Institute of Technology0.7 mi · Cambridge, MA · Urgent care center
Carbon Health Medical Group of Florida PA0.8 mi · Boston, MA · Urgent care center
Carbon Health Medical Group of Texas PLLC0.8 mi · Boston, MA · Urgent care center

Pharmacies

CVS Pharmacy Inc0.1 mi · Boston, MA · Pharmacy
Elysian Enterprises Inc0.1 mi · Boston, MA · Community/retail pharmacy
The General Hospital Corporation0.1 mi · Boston, MA · Community/retail pharmacy

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What The Shriners' Hospital for Children - Boston reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Not reported to Medicare

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	Not reported to Medicare
Deaths within 30 days: heart failure patients	Not reported to Medicare
Deaths within 30 days: pneumonia patients	Not reported to Medicare
Deaths within 30 days: COPD patients	Not reported to Medicare
Deaths within 30 days: stroke patients	Not reported to Medicare
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	Not reported to Medicare
Readmitted within 30 days: pneumonia	Not reported to Medicare
Readmitted within 30 days: COPD	Not reported to Medicare
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Average (median) time patients spent in the emergency room before leaving (OP-18b)	Not reported to Medicare
Patients who left the emergency room before being seen (OP-22)	Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Boston Best hospitals in Boston

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 40 common services exactly as The Shriners' Hospital for Children - Boston lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW LOW 30 MIN	$532.59	$532.59	$46.60 – $817.41
New patient office visit (about 30–44 minutes): 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $75.54 Blue Cross Blue Shield of MA — Commercial: $553.44 Centene NH Healthy Families — Mgd Medicaid: $46.60 Health New England — Medicare Advantage: $75.54 Sana Benefits — Commercial: $105.76 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Well Sense Health Plan NH — Managed Medicaid: $46.60 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$361.40	$361.40	$46.60 – $817.41
New patient office visit (about 30–44 minutes): 10 of 17 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $75.54 Blue Cross Blue Shield of MA — Commercial: $553.44 Health New England — Medicare Advantage: $75.54 Sana Benefits — Commercial: $105.76 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount) Capital District Health Plan — Commercial: 60% (a percentage in the contract, not a dollar amount) Centene Carolina Complete Health — Commercial: 22% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$361.40	$361.40	$75.54 – $817.41
New patient office visit (about 30–44 minutes): 10 of 17 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $75.54 Health New England — Medicare Advantage: $75.54 Sana Benefits — Commercial: $105.76 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of MA — Commercial: 33.15% (a percentage in the contract, not a dollar amount) Capital District Health Plan — Commercial: 60% (a percentage in the contract, not a dollar amount) Centene Carolina Complete Health — Commercial: 22% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW MOD 45 MIN	$864.18	$864.18	$69.90 – $936.86
New patient office visit (about 45–59 minutes): 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $123.86 Blue Cross Blue Shield of MA — Commercial: $936.86 Centene NH Healthy Families — Mgd Medicaid: $69.90 Health New England — Medicare Advantage: $123.86 Sana Benefits — Commercial: $173.40 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Well Sense Health Plan NH — Managed Medicaid: $69.90 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$459.90	$459.90	$69.90 – $936.86
New patient office visit (about 45–59 minutes): 10 of 17 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $123.86 Blue Cross Blue Shield of MA — Commercial: $936.86 Health New England — Medicare Advantage: $123.86 Sana Benefits — Commercial: $173.40 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount) Capital District Health Plan — Commercial: 60% (a percentage in the contract, not a dollar amount) Centene Carolina Complete Health — Commercial: 22% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 57 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$459.90	$459.90	$123.86 – $817.41
New patient office visit (about 45–59 minutes): 10 of 17 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $123.86 Health New England — Medicare Advantage: $123.86 Sana Benefits — Commercial: $173.40 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of MA — Commercial: 33.15% (a percentage in the contract, not a dollar amount) Capital District Health Plan — Commercial: 60% (a percentage in the contract, not a dollar amount) Centene Carolina Complete Health — Commercial: 22% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW HI 60 MIN	$1,175.44	$1,175.44	$88.29 – $1,222.73
New patient office visit (about 60–74 minutes): 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $169.89 Blue Cross Blue Shield of MA — Commercial: $1,222.73 Centene NH Healthy Families — Mgd Medicaid: $88.29 Health New England — Medicare Advantage: $169.89 Sana Benefits — Commercial: $237.85 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Well Sense Health Plan NH — Managed Medicaid: $88.29 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW HI 60 MIN	$680.70	$680.70	$88.29 – $1,222.73
New patient office visit (about 60–74 minutes): 10 of 17 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $169.89 Blue Cross Blue Shield of MA — Commercial: $1,222.73 Health New England — Medicare Advantage: $169.89 Sana Benefits — Commercial: $237.85 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount) Capital District Health Plan — Commercial: 60% (a percentage in the contract, not a dollar amount) Centene Carolina Complete Health — Commercial: 22% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$322.10	$322.10	$46.77 – $817.41
Established patient office visit (about 20–29 minutes): 10 of 17 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $61.04 Blue Cross Blue Shield of MA — Commercial: $370.71 Health New England — Medicare Advantage: $61.04 Sana Benefits — Commercial: $85.46 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount) Capital District Health Plan — Commercial: 60% (a percentage in the contract, not a dollar amount) Centene Carolina Complete Health — Commercial: 22% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20 MIN	$314.20	$314.20	$3,895
Established patient office visit (about 20–29 minutes): rates for 8 insurance plans Capital District Health Plan — Commercial: $3,895 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Health Smart Preferred Care — Commercial: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount) Prime Health Services — Commercial: 85% (a percentage in the contract, not a dollar amount) Providence Health Plan — Commercial: 72% (a percentage in the contract, not a dollar amount) Sana Benefits — Commercial: 70% (a percentage in the contract, not a dollar amount) Stratose — Commercial: 85% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$322.10	$322.10	$61.04 – $817.41
Established patient office visit (about 20–29 minutes): 10 of 17 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $61.04 Health New England — Medicare Advantage: $61.04 Sana Benefits — Commercial: $85.46 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of MA — Commercial: 33.15% (a percentage in the contract, not a dollar amount) Capital District Health Plan — Commercial: 60% (a percentage in the contract, not a dollar amount) Centene Carolina Complete Health — Commercial: 22% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$322.10	$322.10	$72.03 – $817.41
Established patient office visit (about 30–39 minutes): 10 of 17 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $89.67 Blue Cross Blue Shield of MA — Commercial: $571.56 Health New England — Medicare Advantage: $89.67 Sana Benefits — Commercial: $125.54 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount) Capital District Health Plan — Commercial: 60% (a percentage in the contract, not a dollar amount) Centene Carolina Complete Health — Commercial: 22% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30 MIN	$314.20	$314.20	$3,895
Established patient office visit (about 30–39 minutes): rates for 8 insurance plans Capital District Health Plan — Commercial: $3,895 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Health Smart Preferred Care — Commercial: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount) Prime Health Services — Commercial: 85% (a percentage in the contract, not a dollar amount) Providence Health Plan — Commercial: 72% (a percentage in the contract, not a dollar amount) Sana Benefits — Commercial: 70% (a percentage in the contract, not a dollar amount) Stratose — Commercial: 85% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 57 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$322.10	$322.10	$89.67 – $817.41
Established patient office visit (about 30–39 minutes): 10 of 17 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $89.67 Health New England — Medicare Advantage: $89.67 Sana Benefits — Commercial: $125.54 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of MA — Commercial: 33.15% (a percentage in the contract, not a dollar amount) Capital District Health Plan — Commercial: 60% (a percentage in the contract, not a dollar amount) Centene Carolina Complete Health — Commercial: 22% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40	$656.91	$656.91	$92.77 – $817.41
Office consultation with a specialist (moderate to high): 10 of 14 insurance plan rates Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of MA — Commercial: 33.15% (a percentage in the contract, not a dollar amount) Capital District Health Plan — Commercial: 60% (a percentage in the contract, not a dollar amount) Centene Carolina Complete Health — Commercial: 22% (a percentage in the contract, not a dollar amount) Health Smart Preferred Care — Commercial: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount) Prime Health Services — Commercial: 85% (a percentage in the contract, not a dollar amount)

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: METABOLIC PANEL TOTAL CA	$82.10	$82.10	$7.32 – $817.41
Basic metabolic panel (blood test): 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $8.46 AmeriHealth Caritas of NC — Managed Medicaid: $14.62 Blue Cross Blue Shield of MA — Commercial: $29.90 Centene Carolina Complete Health — Commercial: $14.62 Centene NH Healthy Families — Mgd Medicaid: $7.32 Cigna — Commercial: $9.17 Harvard Pilgrim — Commercial: $11.63 Health New England — Medicare Advantage: $8.46 Providence Health Plan — Commercial: $11.76 Sana Benefits — Commercial: $11.84
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$102.40	$102.40	$9.13 – $817.41
Comprehensive metabolic panel (blood test): 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $10.56 AmeriHealth Caritas of NC — Managed Medicaid: $15.41 Blue Cross Blue Shield of MA — Commercial: $37.12 Centene Carolina Complete Health — Commercial: $15.41 Centene NH Healthy Families — Mgd Medicaid: $9.13 Cigna — Commercial: $11.45 Harvard Pilgrim — Commercial: $14.53 Health New England — Medicare Advantage: $10.56 Providence Health Plan — Commercial: $14.68 Sana Benefits — Commercial: $14.78
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$129.80	$129.80	$11.58 – $817.41
Cholesterol panel (lipid panel): 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $13.39 AmeriHealth Caritas of NC — Managed Medicaid: $24.45 Blue Cross Blue Shield of MA — Commercial: $47.43 Centene Carolina Complete Health — Commercial: $24.45 Centene NH Healthy Families — Mgd Medicaid: $11.58 Cigna — Commercial: $14.50 Harvard Pilgrim — Commercial: $18.42 Health New England — Medicare Advantage: $13.39 Providence Health Plan — Commercial: $18.61 Sana Benefits — Commercial: $18.75
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$84.20	$84.20	$7.51 – $817.41
Kidney function panel: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $8.68 AmeriHealth Caritas of NC — Managed Medicaid: $14.62 Blue Cross Blue Shield of MA — Commercial: $30.92 Centene Carolina Complete Health — Commercial: $14.62 Centene NH Healthy Families — Mgd Medicaid: $7.51 Cigna — Commercial: $9.41 Harvard Pilgrim — Commercial: $11.94 Health New England — Medicare Advantage: $8.68 Providence Health Plan — Commercial: $12.07 Sana Benefits — Commercial: $12.15
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$79.20	$79.20	$7.07 – $817.41
Liver function panel: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $8.17 AmeriHealth Caritas of NC — Managed Medicaid: $14.62 Blue Cross Blue Shield of MA — Commercial: $28.87 Centene Carolina Complete Health — Commercial: $14.62 Centene NH Healthy Families — Mgd Medicaid: $7.07 Cigna — Commercial: $8.86 Harvard Pilgrim — Commercial: $11.23 Health New England — Medicare Advantage: $8.17 Providence Health Plan — Commercial: $11.36 Sana Benefits — Commercial: $11.44
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$30.70	$30.70	$2.74 – $817.41
Urine test (automated, with microscope): 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $3.17 AmeriHealth Caritas of NC — Managed Medicaid: $5.78 Blue Cross Blue Shield of MA — Commercial: $11.34 Centene Carolina Complete Health — Commercial: $5.78 Centene NH Healthy Families — Mgd Medicaid: $2.74 Cigna — Commercial: $3.44 Harvard Pilgrim — Commercial: $4.35 Health New England — Medicare Advantage: $3.17 Providence Health Plan — Commercial: $4.41 Sana Benefits — Commercial: $4.44
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE	$24.90	$24.90	$3.01 – $817.41
Urine test (manual, without microscope): 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $3.48 AmeriHealth Caritas of NC — Managed Medicaid: $4.67 Blue Cross Blue Shield of MA — Commercial: $10.31 Centene Carolina Complete Health — Commercial: $4.67 Centene NH Healthy Families — Mgd Medicaid: $3.01 Cigna — Commercial: $3.05 Harvard Pilgrim — Commercial: $3.52 Health New England — Medicare Advantage: $3.48 Providence Health Plan — Commercial: $4.84 Sana Benefits — Commercial: $4.87
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE	$21.80	$21.80	$1.95 – $817.41
Urine test (automated, without microscope): 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $2.25 AmeriHealth Caritas of NC — Managed Medicaid: $4.10 Blue Cross Blue Shield of MA — Commercial: $8.24 Centene Carolina Complete Health — Commercial: $4.10 Centene NH Healthy Families — Mgd Medicaid: $1.95 Cigna — Commercial: $2.43 Harvard Pilgrim — Commercial: $3.09 Health New England — Medicare Advantage: $2.25 Providence Health Plan — Commercial: $3.13 Sana Benefits — Commercial: $3.15
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE	$162.90	$162.90	$14.53 – $817.41
Thyroid stimulating hormone (TSH) test: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $16.80 AmeriHealth Caritas of NC — Managed Medicaid: $29.73 Blue Cross Blue Shield of MA — Commercial: $59.80 Centene Carolina Complete Health — Commercial: $29.73 Centene NH Healthy Families — Mgd Medicaid: $14.53 Cigna — Commercial: $18.21 Harvard Pilgrim — Commercial: $23.10 Health New England — Medicare Advantage: $16.80 Providence Health Plan — Commercial: $23.35 Sana Benefits — Commercial: $23.52
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$75.40	$75.40	$6.72 – $817.41
Complete blood count (CBC) with differential: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $7.77 AmeriHealth Caritas of NC — Managed Medicaid: $14.17 Blue Cross Blue Shield of MA — Commercial: $27.85 Centene Carolina Complete Health — Commercial: $14.17 Centene NH Healthy Families — Mgd Medicaid: $6.72 Cigna — Commercial: $8.41 Harvard Pilgrim — Commercial: $10.69 Health New England — Medicare Advantage: $7.77 Providence Health Plan — Commercial: $10.80 Sana Benefits — Commercial: $10.88
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED	$98.80	$98.80	$5.60 – $817.41
Complete blood count (CBC), automated: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $6.47 AmeriHealth Caritas of NC — Managed Medicaid: $11.81 Blue Cross Blue Shield of MA — Commercial: $22.68 Centene Carolina Complete Health — Commercial: $11.81 Centene NH Healthy Families — Mgd Medicaid: $5.60 Cigna — Commercial: $7.01 Harvard Pilgrim — Commercial: $8.89 Health New England — Medicare Advantage: $6.47 Providence Health Plan — Commercial: $8.99 Sana Benefits — Commercial: $9.06
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME	$38	$38	$3.71 – $817.41
Blood clotting time test (prothrombin time, PT): 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $4.29 AmeriHealth Caritas of NC — Managed Medicaid: $7.17 Blue Cross Blue Shield of MA — Commercial: $13.41 Centene Carolina Complete Health — Commercial: $7.17 Centene NH Healthy Families — Mgd Medicaid: $3.71 Cigna — Commercial: $4.25 Harvard Pilgrim — Commercial: $5.40 Health New England — Medicare Advantage: $4.29 Providence Health Plan — Commercial: $5.96 Sana Benefits — Commercial: $6.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$58.20	$58.20	$5.20 – $817.41
Blood clotting test (partial thromboplastin time, PTT): 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $6.01 AmeriHealth Caritas of NC — Managed Medicaid: $10.95 Blue Cross Blue Shield of MA — Commercial: $21.65 Centene Carolina Complete Health — Commercial: $10.95 Centene NH Healthy Families — Mgd Medicaid: $5.20 Cigna — Commercial: $6.51 Harvard Pilgrim — Commercial: $8.25 Health New England — Medicare Advantage: $6.01 Providence Health Plan — Commercial: $8.35 Sana Benefits — Commercial: $8.41

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O DYE	$1,332.30	$1,332.30	$98.25 – $817.41
CT scan of the head or brain, without contrast: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $125.29 Aetna National — Commercial: $108.61 Blue Cross Blue Shield of MA — Commercial: $125.70 Centene NH Healthy Families — Mgd Medicaid: $98.25 Cigna — Commercial: $138.77 Harvard Pilgrim — Commercial: $173.58 Health New England — Medicare Advantage: $125.29 Providence Health Plan — Commercial: $236.88 Sana Benefits — Commercial: $175.41 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE	$3,657	$3,657	$296.24 – $817.41
MRI of the brain, before and after contrast: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $418.11 Aetna National — Commercial: $342.80 Blue Cross Blue Shield of MA — Commercial: $431.13 Centene NH Healthy Families — Mgd Medicaid: $296.24 Cigna — Commercial: $553.29 Harvard Pilgrim — Commercial: $549.47 Health New England — Medicare Advantage: $418.11 Providence Health Plan — Commercial: $717.12 Sana Benefits — Commercial: $585.35 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM CHEST 2 VIEWS	$368	$368	$30.47 – $817.41
Chest X-ray, 2 views: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $104.29 Aetna National — Commercial: $37 Blue Cross Blue Shield of MA — Commercial: $128.23 Centene NH Healthy Families — Mgd Medicaid: $30.47 Cigna — Commercial: $75.31 Harvard Pilgrim — Commercial: $45.95 Health New England — Medicare Advantage: $104.29 Providence Health Plan — Commercial: $72.72 Sana Benefits — Commercial: $146.01 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS	$513.80	$513.80	$47.18 – $817.41
X-ray of the lower spine, at least 4 views: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $125.29 Aetna National — Commercial: $62.46 Blue Cross Blue Shield of MA — Commercial: $231.59 Centene NH Healthy Families — Mgd Medicaid: $47.18 Cigna — Commercial: $138.77 Harvard Pilgrim — Commercial: $70.84 Health New England — Medicare Advantage: $125.29 Providence Health Plan — Commercial: $110.88 Sana Benefits — Commercial: $175.41 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE	$6,654.80	$6,654.80	$177.84 – $817.41
MRI of the lower back (lumbar spine), without contrast: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $285.95 Aetna National — Commercial: $197.58 Blue Cross Blue Shield of MA — Commercial: $257.60 Centene NH Healthy Families — Mgd Medicaid: $177.84 Cigna — Commercial: $281.65 Harvard Pilgrim — Commercial: $338.49 Health New England — Medicare Advantage: $285.95 Providence Health Plan — Commercial: $429.12 Sana Benefits — Commercial: $400.33 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE	$2,028.90	$2,028.90	$182.22 – $817.41
CT scan of the pelvis, with contrast: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $210.21 Aetna National — Commercial: $279.27 Blue Cross Blue Shield of MA — Commercial: $225.39 Centene NH Healthy Families — Mgd Medicaid: $213.27 Cigna — Commercial: $306.42 Harvard Pilgrim — Commercial: $297.15 Health New England — Medicare Advantage: $210.21 Providence Health Plan — Commercial: $517.68 Sana Benefits — Commercial: $294.29 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	$2,865	$2,865	$188.67 – $817.41
MRI of a leg joint (such as the knee), without contrast: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $285.95 Aetna National — Commercial: $226.63 Blue Cross Blue Shield of MA — Commercial: $257.60 Centene NH Healthy Families — Mgd Medicaid: $188.67 Cigna — Commercial: $281.65 Harvard Pilgrim — Commercial: $338.49 Health New England — Medicare Advantage: $285.95 Providence Health Plan — Commercial: $454.32 Sana Benefits — Commercial: $400.33 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/CONTRAST	$4,176.20	$4,176.20	$282.24 – $817.41
CT scan of the abdomen and pelvis, with contrast: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $418.11 Aetna National — Commercial: $350.35 Blue Cross Blue Shield of MA — Commercial: $431.13 Centene NH Healthy Families — Mgd Medicaid: $282.24 Cigna — Commercial: $306.42 Harvard Pilgrim — Commercial: $482.58 Health New England — Medicare Advantage: $418.11 Providence Health Plan — Commercial: $685.44 Sana Benefits — Commercial: $585.35 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US EXAM ABDOM COMPLETE	$797.50	$797.50	$99.32 – $817.41
Ultrasound of the abdomen, complete: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $125.29 Aetna National — Commercial: $122.79 Blue Cross Blue Shield of MA — Commercial: $231.59 Centene NH Healthy Families — Mgd Medicaid: $105.26 Cigna — Commercial: $138.77 Harvard Pilgrim — Commercial: $99.32 Health New England — Medicare Advantage: $125.29 Providence Health Plan — Commercial: $252.72 Sana Benefits — Commercial: $175.41 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$188.70	$188.70	$32.29 – $817.41
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $32.29 Cigna — Commercial: $130 Health New England — Medicare Advantage: $32.29 Providence Health Plan — Commercial: $139 Sana Benefits — Commercial: $45.21 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 United Healthcare — Nat: $180 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$188.70	$188.70	$32.29 – $817.41
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $32.29 Cigna — Commercial: $130 Health New England — Medicare Advantage: $32.29 Providence Health Plan — Commercial: $139 Sana Benefits — Commercial: $45.21 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 United Healthcare — Nat: $167 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GN In the file: THERAPEUTIC EXERCISES	$184.10	$184.10	$32.29 – $817.41
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $32.29 Cigna — Commercial: $130 Health New England — Medicare Advantage: $32.29 Providence Health Plan — Commercial: $139 Sana Benefits — Commercial: $45.21 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 United Healthcare — Nat: $183 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$242.30	$242.30	$108.88 – $817.41
Physical therapy evaluation (low complexity): 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $108.88 Cigna — Commercial: $130 Health New England — Medicare Advantage: $108.88 Providence Health Plan — Commercial: $163 Sana Benefits — Commercial: $152.43 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 United Healthcare — Nat: $167 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL LOW COMPLEX 20 MIN	$242.20	$242.20	$108.88 – $817.41
Physical therapy evaluation (low complexity): 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $108.88 Cigna — Commercial: $130 Health New England — Medicare Advantage: $108.88 Providence Health Plan — Commercial: $163 Sana Benefits — Commercial: $152.43 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 United Healthcare — Nat: $167 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$242.30	$242.30	$108.88 – $817.41
Physical therapy evaluation (low complexity): 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $108.88 Cigna — Commercial: $130 Health New England — Medicare Advantage: $108.88 Providence Health Plan — Commercial: $163 Sana Benefits — Commercial: $152.43 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 United Healthcare — Nat: $167 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$363.50	$363.50	$108.88 – $817.41
Physical therapy evaluation (moderate complexity): 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $108.88 Cigna — Commercial: $130 Health New England — Medicare Advantage: $108.88 Providence Health Plan — Commercial: $163 Sana Benefits — Commercial: $152.43 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 United Healthcare — Nat: $167 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$363.50	$363.50	$108.88 – $817.41
Physical therapy evaluation (moderate complexity): 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $108.88 Cigna — Commercial: $130 Health New England — Medicare Advantage: $108.88 Providence Health Plan — Commercial: $163 Sana Benefits — Commercial: $152.43 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 United Healthcare — Nat: $167 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: PT EVAL HIGH COMPLEX 45 MIN	$545.40	$545.40	$108.88 – $817.41
Physical therapy evaluation (high complexity): 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $108.88 Cigna — Commercial: $130 Health New England — Medicare Advantage: $108.88 Providence Health Plan — Commercial: $163 Sana Benefits — Commercial: $152.43 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 United Healthcare — Nat: $167 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$5,688.45	$5,688.45	$817.41 – $6,365
Groin (inguinal) hernia repair, age 5 or older: 10 of 21 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $4,290.92 Aetna National — Commercial: $1,924 Cigna — Commercial: $1,664 Health New England — Medicare Advantage: $5,363.65 Providence Health Plan — Commercial: $6,365 Sana Benefits — Commercial: $6,007.29 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 United Healthcare — Nat: $1,982 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	$5,128.42	$5,128.42	$136.54 – $1,525
Nerve root injection, lower back, with imaging guidance: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $1,059.99 Blue Cross Blue Shield of MA — Commercial: $1,230.62 Centene NH Healthy Families — Mgd Medicaid: $136.54 Harvard Pilgrim — Commercial: $1,525 Health New England — Medicare Advantage: $1,059.99 Sana Benefits — Commercial: $1,483.99 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	$10,817.48	$10,817.48	$218.97 – $3,276.34
Carpal tunnel release: 10 of 22 insurance plan rates Aetna Better Health of Michigan — Managed Medicaid: $2,340.24 Blue Cross Blue Shield of MA — Commercial: $2,625.03 Centene NH Healthy Families — Mgd Medicaid: $218.97 Harvard Pilgrim — Commercial: $1,525 Health New England — Medicare Advantage: $2,340.24 Sana Benefits — Commercial: $3,276.34 Tufts Network Health Public Plan — Mgd. Medicaid: $817.41 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$3,895 – $103,421.19
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 15 insurance plan rates Aetna National — Commercial: $90,179.88 AmeriHealth Caritas of NC — Managed Medicaid: $31,432.24 AmeriHealth Caritas of NH — Managed Medicaid: $62,710.63 Capital District Health Plan — Commercial: $3,895 Centene Carolina Complete Health — Commercial: $31,432.24 Centene NH Healthy Families — Mgd Medicaid: $63,062.81 Providence Health Plan — Managed Medicaid: $75,336.49 United Healthcare — Nat: $103,421.19 Well Sense Health Plan NH — Managed Medicaid: $62,710.63 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount)
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Spinal fusion except cervical without major comorbid conditions or complications	Not listed in the file	Not listed in the file	$3,895 – $23,768.19
Spinal fusion (not neck), without major complications: rates for 8 insurance plans Capital District Health Plan — Commercial: $3,895 Centene NH Healthy Families — Mgd Medicaid: $23,768.19 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Health Smart Preferred Care — Commercial: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount) Prime Health Services — Commercial: 85% (a percentage in the contract, not a dollar amount) Sana Benefits — Commercial: 70% (a percentage in the contract, not a dollar amount) Stratose — Commercial: 85% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	Not listed in the file	Not listed in the file	$3,895 – $20,205.02
Hip or knee replacement (major joint of the leg), without major complications: 10 of 15 insurance plan rates Aetna National — Commercial: $17,618.11 AmeriHealth Caritas of NC — Managed Medicaid: $5,926.37 AmeriHealth Caritas of NH — Managed Medicaid: $12,251.55 Capital District Health Plan — Commercial: $3,895 Centene Carolina Complete Health — Commercial: $5,926.37 Centene NH Healthy Families — Mgd Medicaid: $12,226.85 Providence Health Plan — Managed Medicaid: $14,718.21 United Healthcare — Nat: $20,205.02 Well Sense Health Plan NH — Managed Medicaid: $12,251.55 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$3,895 – $25,369.06
Neck (cervical) spinal fusion, without complications: 10 of 15 insurance plan rates Aetna National — Commercial: $22,120.99 AmeriHealth Caritas of NC — Managed Medicaid: $6,499.45 AmeriHealth Caritas of NH — Managed Medicaid: $15,382.82 Capital District Health Plan — Commercial: $3,895 Centene Carolina Complete Health — Commercial: $6,499.45 Centene NH Healthy Families — Mgd Medicaid: $15,988.41 Providence Health Plan — Managed Medicaid: $18,479.92 United Healthcare — Nat: $25,369.06 Well Sense Health Plan NH — Managed Medicaid: $15,382.82 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$2,740.20 – $12,845.27
Uterus and ovary surgery (not for cancer), without complications: 10 of 15 insurance plan rates Aetna National — Commercial: $11,200.65 AmeriHealth Caritas of NC — Managed Medicaid: $2,740.20 AmeriHealth Caritas of NH — Managed Medicaid: $7,788.88 Capital District Health Plan — Commercial: $3,895 Centene Carolina Complete Health — Commercial: $2,740.20 Centene NH Healthy Families — Mgd Medicaid: $7,550.41 Providence Health Plan — Managed Medicaid: $9,357.05 United Healthcare — Nat: $12,845.27 Well Sense Health Plan NH — Managed Medicaid: $7,788.88 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount)

Source: The Shriners' Hospital for Children - Boston’s standard charges file (apim.services.craneware.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 17, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Children's Hospital
Address	51 Blossom Street, Boston, MA 02114
County	Suffolk County
State	Massachusetts
Phone	(617) 722‑3000
Emergency services	Not listed
Ownership	Proprietary
Medicare overall rating	Not rated by CMS
CMS Certification Number	223304
Name in Medicare records	THE SHRINERS' HOSPITAL FOR CHILDREN - BOSTON
Profile level	Medicare data + hospital website
Name on the hospital’s website	Shriners Children's Boston
Official website	shrinerschildrens.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Pediatric Specialty Care in Boston — shrinerschildrens.org
Visiting Us — shrinerschildrens.org
Amenities & Services | Shriners Children's Boston — shrinerschildrens.org
Patient Programs | Shriners Children's Boston — shrinerschildrens.org
Getting Here | Shriners Children's — shrinerschildrens.org
About Us | Shriners Children's Boston — shrinerschildrens.org
Our Treatment Approach | Shriners Children’s Boston — shrinerschildrens.org
Our Affiliations and Partners — shrinerschildrens.org
Interpreter Services | Shriners Children's — shrinerschildrens.org
our-care — shrinerschildrens.org