Does UMass Memorial Medical Center/University Campus have an emergency room?

Yes. Medicare (CMS) data lists emergency services at UMass Memorial Medical Center/University Campus. In a medical emergency, call 911.

Where is UMass Memorial Medical Center/University Campus?

55 Lake Avenue North, Worcester, MA 01655, in Worcester County, Massachusetts.

What is the phone number of UMass Memorial Medical Center/University Campus?

(508) 334-1000, as listed by Medicare (CMS).

What is the Medicare star rating of UMass Memorial Medical Center/University Campus?

3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

UMass Memorial Medical Center/University Campus

Quick answers

Does UMass Memorial Medical Center/University Campus have an emergency room?: Yes. Medicare (CMS) data lists emergency services at UMass Memorial Medical Center/University Campus. In a medical emergency, call 911.
Where is UMass Memorial Medical Center/University Campus?: 55 Lake Avenue North, Worcester, MA 01655, in Worcester County, Massachusetts.
What is the phone number of UMass Memorial Medical Center/University Campus?: (508) 334-1000, as listed by Medicare (CMS).
What is the Medicare star rating of UMass Memorial Medical Center/University Campus?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4]

Allergy and Asthma
Audiology
Cancer Care
Children's Medical Center / Pediatrics
Colon and Rectal Surgery
Dermatology
Developmental and Behavioral Pediatrics
Ear, Nose and Throat (ENT)
Endocrinology and Metabolism
Gastroenterology
General Surgery
Geriatric Medicine
Heart and Vascular Care
Infectious Diseases
Internal Medicine
Nephrology
Neurology
Neuropsychology
Neurosurgery
Nuclear Medicine
Orthopedics
Palliative Care
Pediatric Endocrinology
Pediatric Hematology and Cancer Care
Pediatric Nephrology
Pediatric Neurology
Pediatric Neurosurgery
Pediatric Orthopedics
Pediatric Palliative Care
Pediatric Surgery
Pediatric Urology
Physiatry
Podiatry
Primary Care
Psychiatry
Pulmonary Medicine
Radiology and Imaging
Rheumatology
Spine Care
Thoracic Surgery

Conditions treated^[4]

Sickle cell disease

Treatments^[4]

Chemotherapy and Medical Oncology
Bone Marrow Transplant
Kidney Transplant
Wound Care
Bone density testing
Cancer care
Mammography and breast imaging
MRI and CT scans
Nuclear medicine imaging and therapy
Lab services
Spine care
Bariatric (weight loss) surgery
Sickle cell disease
Neuropsychology
Arthritis and joint replacement
Thoracic surgery

Procedures^[4]

Bariatric (Weight Loss) Surgery
Bone Density Testing
Mammography and Breast Imaging

Programs and centers^[4]

Advanced Therapeutics Program (ATRX)
Hydrocephalus Program
Toxicology and Poison Care

Emergency care (hospital website)^[4][5]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Parking	Hourly-fee patient/visitor parking in the South Garage on South Road; valet at main entrance, ER and Ambulatory Care Center^[4]

Doctors and clinicians (2,696)

2,696 doctors and other clinicians list UMass Memorial Medical Center/University Campus as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Nurse Practitioner428
Internal Medicine408
Physician Assistant272
Family Practice219
Certified Registered Nurse Anesthetist (CRNA)150
Emergency Medicine130
Diagnostic Radiology113
Anesthesiology99
Obstetrics/Gynecology75
Cardiovascular Disease (Cardiology)70
Neurology67
Gastroenterology51

And 2,672 more: the button below opens the full list.

Other emergency rooms nearby

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

St Vincent Hospital2.0 mi · Worcester, MA · Acute Care Hospital
Marlborough Hospital12 mi · Marlborough, MA · Acute Care Hospital
Milford Regional Medical Center15 mi · Milford, MA · Acute Care Hospital
Metrowest Medical Center17 mi · Framingham, MA · Acute Care Hospital
UMass Memorial Healthalliance Hospitals18 mi · Leominster, MA · Acute Care Hospital

Other hospitals nearby

Worcester Recovery Center and Hospital0.4 mi · Worcester, MA · Psychiatric Hospital
Adcare Hospital of Worcester Inc1.8 mi · Worcester, MA · Acute Care Hospital
Hospital for Behavioral Medicine3.1 mi · Worcester, MA · Psychiatric Hospital
Fairlawn Rehab Hosp, An Affiliate of Encompass HLT…4.0 mi · Worcester, MA · Inpatient Rehabilitation 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.

Nursing homes

Notre Dame Long Term Care Center0.8 mi · Worcester, MA · 4 of 5 stars
Christopher House of Worcester1.0 mi · Worcester, MA · 3 of 5 stars
Regalcare at Worcester1.4 mi · Worcester, MA · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Notre Dame Hospice1.7 mi · Worcester, MA · 4 of 5 stars
Ascend Hospice1.7 mi · Worcester, MA · 3 of 5 stars
VNA Care Hospice Inc3.1 mi · Worcester, MA · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Century Homecare LLC1.7 mi · Worcester, MA
Complete VNA1.7 mi · Worcester, MA · 3 of 5 stars
Loyal Home Care Services1.7 mi · Worcester, MA

All home health agencies in the state →

Dialysis facilities

DaVita PDI Worcester1.7 mi · Worcester, MA · 3 of 5 stars
FMC - Freedom Center of Worcester1.7 mi · Worcester, MA · 3 of 5 stars
Fresenius Kidney Care Worcester County Dialysis1.7 mi · Worcester, MA · 5 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

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

Surgical Eye Experts LLC1.7 mi · Worcester, MA
Worcester Surgical Center, Inc1.7 mi · Worcester, MA
The Surgery Center2.4 mi · Shrewsbury, 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

Worcester Technical High SCHOOL-B124-1250.9 mi · Worcester, MA · Community health center
North High School Hlth CENTER-112-A, I, K, M1.2 mi · Worcester, MA · Community health center
605 Lincoln Street1.4 mi · Worcester, MA · Community health center

Clinics and urgent care

Urgent Care Centers of Central Massachusetts, LLC1.7 mi · Worcester, MA · Urgent care center
Urgent Care Operations PC1.7 mi · Worcester, MA · Urgent care center
AFC Physicians of Massachusetts3.1 mi · Worcester, MA · Urgent care center

Pharmacies

Edward M. Kennedy Community Health Center, Inc1.7 mi · Worcester, MA · Clinic pharmacy
Edward M. Kennedy Community Health Center, Inc1.7 mi · Worcester, MA · Community/retail pharmacy
Shaws Supermarkets Inc1.7 mi · Worcester, 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 UMass Memorial Medical Center/University Campus 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.

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	69%National average: 72%
Would definitely recommend the hospital	72%National average: 71%
Nurses “always” communicated well	80%National average: 80%
Doctors “always” communicated well	77%National average: 80%
Staff “always” explained medicines before giving them	61%National average: 62%
Were given information about recovery at home	88%National average: 86%
Room and bathroom “always” clean	69%National average: 74%
Area around the room “always” quiet at night	42%National average: 60%
Completed surveys	1,116Response rate: 22%

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)	0.469Better than the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.418Better than the national benchmark
Surgical site infections after colon surgery	0.838No different from the national benchmark
Surgical site infections after abdominal hysterectomy	2.228No different from the national benchmark
MRSA bloodstream infections	0.912No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.351Better than the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

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	11%
Deaths within 30 days: heart failure patients	10.3%
Deaths within 30 days: pneumonia patients	11.9%
Deaths within 30 days: COPD patients	7.8%
Deaths within 30 days: stroke patients	12.6%
Deaths within 30 days: coronary bypass surgery (CABG)	2.2%
Serious complications (patient safety indicator PSI-90)	0.97No different from the national rate
Complications after hip or knee replacement	3.6%

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2025.

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	14.5%
Readmitted within 30 days: heart failure	20.3%
Readmitted within 30 days: pneumonia	16.6%
Readmitted within 30 days: COPD	20.3%
Readmitted within 30 days: coronary bypass surgery	11.4%
Readmitted within 30 days: hip or knee replacement	6.2%

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 to June 2025.

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.

Emergency room volume (patients per year)	Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	291 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	8%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	58%National average: 65%

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

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 Worcester Best hospitals in Massachusetts

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 77 common services exactly as UMass Memorial Medical Center/University Campus 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 →

$ 39 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: HC PR Bh Level 3 Outpatient New Pt Visit	$307	$307	$35.91 – $672.16
New patient office visit (about 30–44 minutes): 10 of 57 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $200.16 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $307 BCBS [10301] — All BC HMO UM [11] Plans: $233.68 BCBS [10301] — All BC PPO UM [44] Plans: $260.36 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $307 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $60.05 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $71.92 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $61.03 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $307 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $102.87
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: New Pt. Labor Check 61-120 Minutes	$174	$174	$35.91 – $672.16
New patient office visit (about 30–44 minutes): 10 of 53 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $113.45 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $174 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $174 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $164.85 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $163.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $167.53 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $174 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $159.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $159.56 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $167.53
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: HC Level 3 Outpatient New Pt Visit	$228	$228	$58 – $672.16
New patient office visit (about 30–44 minutes): 10 of 47 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $148.66 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $228 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $228 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $164.85 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $163.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $167.53 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $228 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $159.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $159.56 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $167.53
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: HC PR Bh Level 4 Outpatient New Pt Visit	$455	$455	$35.91 – $672.16
New patient office visit (about 45–59 minutes): 10 of 57 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $296.66 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $455 BCBS [10301] — All BC HMO UM [11] Plans: $395.58 BCBS [10301] — All BC PPO UM [44] Plans: $440.74 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $455 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $88.25 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $117.83 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $89.68 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $455 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $151.18
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: New Pt. Labor Check 121-240 Minutes	$206	$206	$35.91 – $672.16
New patient office visit (about 45–59 minutes): 10 of 53 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $134.31 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $206 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $206 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $164.85 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $163.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $167.53 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $206 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $159.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $159.56 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $167.53
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: HC Level 4 Outpatient New Pt Visit	$228	$228	$58 – $672.16
New patient office visit (about 45–59 minutes): 10 of 47 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $148.66 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $228 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $228 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $164.85 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $163.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $167.53 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $228 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $159.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $159.56 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $167.53
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: HC PR Bh Level 5 Outpatient New Pt Visit	$586	$586	$35.91 – $672.16
New patient office visit (about 60–74 minutes): 10 of 57 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $382.07 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $586 BCBS [10301] — All BC HMO UM [11] Plans: $516.28 BCBS [10301] — All BC PPO UM [44] Plans: $575.22 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $586 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $131.21 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $161.42 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $133.34 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $586 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $224.77
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: New Pt. Labor Check 241-480 Minutes	$268	$268	$35.91 – $672.16
New patient office visit (about 60–74 minutes): 10 of 53 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $174.74 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $268 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $268 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $164.85 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $163.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $167.53 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $268 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $159.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $159.56 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $167.53
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: HC Level 5 Outpatient New Pt Visit	$228	$228	$58 – $672.16
New patient office visit (about 60–74 minutes): 10 of 47 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $148.66 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $228 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $228 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $164.85 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $163.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $167.53 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $228 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $159.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $159.56 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $167.53
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: HC PR Bh Level 3 Outpatient Est Pt Visit	$258	$258	$35.91 – $672.16
Established patient office visit (about 20–29 minutes): 10 of 57 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $168.22 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $258 BCBS [10301] — All BC HMO UM [11] Plans: $156.53 BCBS [10301] — All BC PPO UM [44] Plans: $174.40 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $258 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $60.05 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $58.12 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $61.03 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $258 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $102.87
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: Est. Pt. Labor Check 61-120 Minutes	$149	$149	$35.91 – $672.16
Established patient office visit (about 20–29 minutes): 10 of 53 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $97.15 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $149 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $149 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $164.85 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $163.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $167.53 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $149 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $159.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $159.56 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $167.53
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: HC Level 3 Outpatient Est Pt Visit	$228	$228	$58 – $672.16
Established patient office visit (about 20–29 minutes): 10 of 47 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $148.66 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $228 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $228 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $164.85 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $163.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $167.53 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $228 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $159.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $159.56 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $167.53
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: HC PR Bh Level 4 Outpatient Est Pt Visit	$351	$351	$35.91 – $672.16
Established patient office visit (about 30–39 minutes): 10 of 57 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $228.85 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $351 BCBS [10301] — All BC HMO UM [11] Plans: $241.34 BCBS [10301] — All BC PPO UM [44] Plans: $268.89 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $351 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $88.25 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $85.41 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $89.68 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $351 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $151.18
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: Est. Pt. Labor Check 121-240 Minutes	$193	$193	$35.91 – $672.16
Established patient office visit (about 30–39 minutes): 10 of 53 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $125.84 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $193 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $193 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $164.85 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $163.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $167.53 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $193 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $159.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $159.56 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $167.53
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: HC Level 4 Outpatient Est Pt Visit	$228	$228	$53.87 – $672.16
Established patient office visit (about 30–39 minutes): 10 of 47 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $148.66 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $228 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $228 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $164.85 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $163.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $167.53 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $228 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $159.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $159.56 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $167.53
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: HC Initial Preventive Medicine Exam, New Patient; Age 18-39yrs	$168	$168	$56.95 – $672.16
Preventive checkup, new patient, age 18–39: 10 of 43 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $109.54 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $168 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $168 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $168 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $168 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $168 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $168 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $168 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $134.40 FALLON CONNECTORCARE [10503] — All FALLON HMO UM [99] Plans: $79.63
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · modifier 25\|TC In the file: HC Initial Preventive Medicine Exam, New Patient; Age 18-39yrs\|SIGNIFICANT, SEPARATELY IDENTIFIABLE EVALUATION AND MANAGEMENT SERVICE BY THE	$168	$168	$56.95 – $672.16
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $139
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient · modifier TC In the file: HC Initial Preventive Medicine Exam, New Patient; Age 18-39yrs\|TECHNICAL COMPONENT	$168	$168	$56.95 – $672.16
Preventive checkup, new patient, age 18–39: rates for 1 insurance plan BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $139
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: HC Initial Preventive Medicine Exam, New Patient; Age 40-64 Yrs	$168	$168	$56.95 – $672.16
Preventive checkup, new patient, age 40–64: 10 of 43 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $109.54 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $168 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $168 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $168 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $168 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $168 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $168 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $168 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $134.40 FALLON CONNECTORCARE [10503] — All FALLON HMO UM [99] Plans: $79.63
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · modifier 25 In the file: HC Initial Preventive Medicine Exam, New Patient; Age 40-64 Yrs\|SIGNIFICANT, SEPARATELY IDENTIFIABLE EVALUATION AND MANAGEMENT SERVICE BY TH	$168	$168	$56.95 – $672.16
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $139
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient · modifier 59 In the file: HC Initial Preventive Medicine Exam, New Patient; Age 40-64 Yrs\|DISTINCT PROCEDURAL SERVICE	$168	$168	$56.95 – $672.16
Preventive checkup, new patient, age 40–64: rates for 1 insurance plan BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $139
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: HC Level 3 Emergency Department Visit	$2,425	$2,425	$173.88 – $2,425
Emergency room visit (moderate): 10 of 59 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $1,581.10 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $2,425 BCBS [10301] — All BC HMO UM [11] Plans: $473.54 BCBS [10301] — All BC PPO UM [44] Plans: $527.60 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $2,425 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $342.19 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $352.17 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $1,525.30 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $347.76 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $2,425
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · modifier 52 In the file: HC Level 3 Emergency Department Visit\|REDUCED SERVICES	$2,425	$2,425	$173.88 – $2,425
Emergency room visit (moderate): 10 of 24 insurance plan rates BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $342.19 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $352.17 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $347.76 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $331.20 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $331.20 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $347.76 FALLON CONNECTORCARE [10503] — All FALLON HMO UM [99] Plans: $574.73 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $347.76 HARVARD PILGRIM MCR SUPP [20203] — All HARVARD PILGRIM MCR UM [140] Plans: $347.76 INSTITUTION [10406] — All HOSPICE GENERIC [237] Plans: $331.20
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: HC Level 4 Emergency Department Visit	$3,502	$3,502	$457.73 – $3,502
Emergency room visit (moderately high): 10 of 59 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $2,283.30 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $3,502 BCBS [10301] — All BC HMO UM [11] Plans: $765.27 BCBS [10301] — All BC PPO UM [44] Plans: $852.63 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $3,502 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $516.67 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $541.59 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $2,946.96 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $525.07 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $3,502
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: HC Level 5 Emergency Department Visit	$4,226	$4,226	$457.73 – $4,226
Emergency room visit (high): 10 of 59 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $2,755.35 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $4,226 BCBS [10301] — All BC HMO UM [11] Plans: $1,115.52 BCBS [10301] — All BC PPO UM [44] Plans: $1,242.87 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $4,226 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $737.41 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $779.79 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $2,946.96 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $749.40 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $4,226

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: HC Basic Metabolic	$94	$94	$7.46 – $672.16
Basic metabolic panel (blood test): 10 of 61 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $61.29 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $94 BCBS [10301] — All BC HMO UM [11] Plans: $34.45 BCBS [10301] — All BC PPO UM [44] Plans: $34.45 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $94 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $8.74 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $10.19 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $17.99 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $8.88 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $94
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: HC Bmp Calcium Total Panel 8 Tests	$94	$94	$7.46 – $672.16
Basic metabolic panel (blood test): 10 of 61 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $61.29 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $94 BCBS [10301] — All BC HMO UM [11] Plans: $34.45 BCBS [10301] — All BC PPO UM [44] Plans: $34.45 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $94 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $8.74 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $10.19 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $17.99 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $8.88 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $94
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: HC Comprehensive Metabolic	$135	$135	$10.56 – $672.16
Comprehensive metabolic panel (blood test): 10 of 61 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $88.02 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $135 BCBS [10301] — All BC HMO UM [11] Plans: $43.06 BCBS [10301] — All BC PPO UM [44] Plans: $43.06 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $135 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $10.91 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $12.72 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $22.46 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $11.09 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $135
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: HC Comprehesive Metabolic Panel	$181	$181	$10.56 – $672.16
Comprehensive metabolic panel (blood test): 10 of 61 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $118.01 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $181 BCBS [10301] — All BC HMO UM [11] Plans: $43.06 BCBS [10301] — All BC PPO UM [44] Plans: $43.06 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $181 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $10.91 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $12.72 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $22.46 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $11.09 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $181
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: HC Lipid Panel	$141	$141	$11.81 – $672.16
Cholesterol panel (lipid panel): 10 of 67 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $91.93 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $141 BCBS [10301] — All BC HMO UM [11] Plans: $74.28 BCBS [10301] — All BC PPO UM [44] Plans: $74.28 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $130 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $13.83 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $16.13 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $27.69 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $14.06 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $141
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: HC Renal Function Panel	$109	$109	$7.65 – $672.16
Kidney function panel: 10 of 60 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $71.07 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $109 BCBS [10301] — All BC HMO UM [11] Plans: $35.54 BCBS [10301] — All BC PPO UM [44] Plans: $35.54 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $109 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $8.97 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $10.46 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $18.46 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $9.11 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $109
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: HC Renal Function Panel 10 Tests	$100	$100	$7.65 – $672.16
Kidney function panel: 10 of 60 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $65.20 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $100 BCBS [10301] — All BC HMO UM [11] Plans: $35.54 BCBS [10301] — All BC PPO UM [44] Plans: $35.54 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $100 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $8.97 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $10.46 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $18.46 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $9.11 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $100
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HC Hepatic Panel	$177	$177	$7.20 – $672.16
Liver function panel: 10 of 61 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $115.40 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $177 BCBS [10301] — All BC HMO UM [11] Plans: $33.38 BCBS [10301] — All BC PPO UM [44] Plans: $33.38 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $177 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $8.44 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $9.84 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $17.37 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $8.58 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $177
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HC Hepatic Function Panel	$221	$221	$7.20 – $672.16
Liver function panel: 10 of 61 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $144.09 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $221 BCBS [10301] — All BC HMO UM [11] Plans: $33.38 BCBS [10301] — All BC PPO UM [44] Plans: $33.38 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $221 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $8.44 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $9.84 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $17.37 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $8.58 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $221
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: Urinalysis, Auto, W/Scope	$68.25	$68.25	$2.80 – $672.16
Urine test (automated, with microscope): 10 of 68 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $44.50 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $68.25 BCBS [10301] — All BC HMO UM [11] Plans: $16.38 BCBS [10301] — All BC PPO UM [44] Plans: $16.38 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $68.25 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $3.28 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $3.82 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $6.73 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $3.33 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $68.25
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: HC Urinalysis Auto W/Scope	$87	$87	$2.80 – $672.16
Urine test (automated, with microscope): 10 of 68 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $56.72 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $87 BCBS [10301] — All BC HMO UM [11] Plans: $16.38 BCBS [10301] — All BC PPO UM [44] Plans: $16.38 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $87 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $3.28 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $3.82 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $6.73 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $3.33 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $87
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: Urinalysis Nonauto W/O Scope	$7.49	$7.49	$2.44 – $672.16
Urine test (manual, without microscope): 10 of 69 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $4.88 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $7.49 BCBS [10301] — All BC HMO UM [11] Plans: $14.90 BCBS [10301] — All BC PPO UM [44] Plans: $14.90 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $7.49 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $3.60 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $4.19 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $5.45 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $3.65 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $7.49
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: HC Urinalysis Non Auto W/O Microscopy	$126	$126	$2.44 – $672.16
Urine test (manual, without microscope): 10 of 69 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $82.15 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $126 BCBS [10301] — All BC HMO UM [11] Plans: $14.90 BCBS [10301] — All BC PPO UM [44] Plans: $14.90 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $126 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $3.60 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $4.19 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $5.45 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $3.65 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $126
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC Urinalysis Dip Stick/ Tablet Reagent Automated W/O Microscopy	$83	$83	$1.98 – $672.16
Urine test (automated, without microscope): 10 of 68 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $54.12 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $83 BCBS [10301] — All BC HMO UM [11] Plans: $11.91 BCBS [10301] — All BC PPO UM [44] Plans: $11.91 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $83 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $2.32 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $2.71 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4.78 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $2.36 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $83
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC Urinalysis	$87	$87	$1.98 – $672.16
Urine test (automated, without microscope): 10 of 68 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $56.72 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $87 BCBS [10301] — All BC HMO UM [11] Plans: $11.91 BCBS [10301] — All BC PPO UM [44] Plans: $11.91 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $87 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $2.32 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $2.71 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4.78 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $2.36 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $87
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: HC Psa Total	$302	$302	$16.22 – $672.16
PSA (prostate specific antigen) blood test: 10 of 65 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $196.90 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $302 BCBS [10301] — All BC HMO UM [11] Plans: $93.83 BCBS [10301] — All BC PPO UM [44] Plans: $93.83 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $302 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $19 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $22.16 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $39.11 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $19.31 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $302
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: HC Thyroid Stimulating Hormone (Tsh)	$537	$537	$14.82 – $672.16
Thyroid stimulating hormone (TSH) test: 10 of 68 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $350.12 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $537 BCBS [10301] — All BC HMO UM [11] Plans: $86.37 BCBS [10301] — All BC PPO UM [44] Plans: $86.37 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $537 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $17.36 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $20.24 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $35.73 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $17.64 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $537
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: HC Tsh	$742	$742	$14.82 – $742
Thyroid stimulating hormone (TSH) test: 10 of 68 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $483.78 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $742 BCBS [10301] — All BC HMO UM [11] Plans: $86.37 BCBS [10301] — All BC PPO UM [44] Plans: $86.37 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $742 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $17.36 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $20.24 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $35.73 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $17.64 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $742
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: HC Cbc W Auto Diff	$175	$175	$6.85 – $672.16
Complete blood count (CBC) with differential: 10 of 69 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $99.76 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $153 BCBS [10301] — All BC HMO UM [11] Plans: $40.22 BCBS [10301] — All BC PPO UM [44] Plans: $40.22 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $153 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $8.03 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $9.36 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $16.53 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $8.16 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $153
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HC Complete Cbc Auto	$96	$96	$5.71 – $672.16
Complete blood count (CBC), automated: 10 of 68 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $62.59 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $96 BCBS [10301] — All BC HMO UM [11] Plans: $32.76 BCBS [10301] — All BC PPO UM [44] Plans: $32.76 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $96 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $6.68 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $7.80 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $13.75 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $6.79 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $96
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HC Cbc	$105	$105	$5.71 – $672.16
Complete blood count (CBC), automated: 10 of 68 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $68.46 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $105 BCBS [10301] — All BC HMO UM [11] Plans: $32.76 BCBS [10301] — All BC PPO UM [44] Plans: $32.76 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $105 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $6.68 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $7.80 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $13.75 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $6.79 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $105
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: HC Inr	$89	$89	$3.76 – $672.16
Blood clotting time test (prothrombin time, PT): 10 of 68 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $58.03 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $89 BCBS [10301] — All BC HMO UM [11] Plans: $19.37 BCBS [10301] — All BC PPO UM [44] Plans: $19.37 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $89 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4.43 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $5.17 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $8.35 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4.50 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $89
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: Prothrombin Time	$33.20	$33.20	$3.76 – $672.16
Blood clotting time test (prothrombin time, PT): 10 of 68 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $21.65 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $33.20 BCBS [10301] — All BC HMO UM [11] Plans: $19.37 BCBS [10301] — All BC PPO UM [44] Plans: $19.37 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $33.20 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4.43 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $5.17 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $8.35 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4.50 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $33.20
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: HC Prothrombin Time	$96	$96	$3.76 – $672.16
Blood clotting time test (prothrombin time, PT): 10 of 68 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $62.59 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $96 BCBS [10301] — All BC HMO UM [11] Plans: $19.37 BCBS [10301] — All BC PPO UM [44] Plans: $19.37 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $96 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4.43 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $5.17 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $8.35 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4.50 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $96
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: HC Thromboplastin Time Partial Plasma or Whole Blood	$108	$108	$5.30 – $672.16
Blood clotting test (partial thromboplastin time, PTT): 10 of 68 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $70.42 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $108 BCBS [10301] — All BC HMO UM [11] Plans: $31.28 BCBS [10301] — All BC PPO UM [44] Plans: $31.28 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $108 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $6.21 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $7.24 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $12.75 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $6.31 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $108

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 · Inpatient or outpatient In the file: HC CT Head or Brain W/O Contrast	$2,466	$2,466	$125.29 – $2,466
CT scan of the head or brain, without contrast: 10 of 54 insurance plan rates AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $2,466 BCBS [10301] — All BC HMO UM [11] Plans: $323.32 BCBS [10301] — All BC PPO UM [44] Plans: $323.32 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $2,466 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $129.45 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $135.25 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $1,444.50 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $131.56 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $2,466 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $1,444.50
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · modifier 59 In the file: HC CT Head or Brain W/O Contrast\|DISTINCT PROCEDURAL SERVICE	$2,466	$2,466	$125.29 – $2,466
CT scan of the head or brain, without contrast: 10 of 17 insurance plan rates BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $131.05 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $133.19 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $126.84 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $126.84 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $133.19 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $133.19 HARVARD PILGRIM MCR SUPP [20203] — All HARVARD PILGRIM MCR UM [140] Plans: $133.19 INSTITUTION [10406] — All HOSPICE GENERIC [237] Plans: $126.84 INSTITUTION [10406] — All HOSPICE UM [288] Plans: $126.84 MEDICARE [20206] — All MEDICARE/ MEDICARE ADV PLANS/ INST UM [67] Plans: $126.84
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: HC MRI Brain W/O Fol W Contrast	$5,423	$5,423	$418.11 – $5,423
MRI of the brain, before and after contrast: 10 of 54 insurance plan rates AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $5,423 BCBS [10301] — All BC HMO UM [11] Plans: $1,108.94 BCBS [10301] — All BC PPO UM [44] Plans: $1,108.94 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $5,423 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $437.33 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $454.23 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,572.57 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $444.45 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $5,423 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,572.57
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: HC X-Ray Exam Chest 2 Views	$651	$651	$104.29 – $672.16
Chest X-ray, 2 views: 10 of 59 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $424.45 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $651 BCBS [10301] — All BC HMO UM [11] Plans: $185.22 BCBS [10301] — All BC PPO UM [44] Plans: $185.22 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $651 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $107.76 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $111.99 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $524.84 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $109.51 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $651
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: HC X-Ray Exam Chest 2 Views	$879	$879	$5.33 – $3,563.91
Chest X-ray, 2 views: 10 of 58 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $185.22 BCBS [10301] — All BC PPO UM [44] Plans: $185.22 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $107.76 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $111.99 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $109.51 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $104.29 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $104.29 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $109.51 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $109.51 HARVARD PILGRIM [10701] — All HARVARD PILGRIM BETH ISRAEL LAHEY UM [260] Plans: $214.94
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier 59 In the file: HC X-Ray Exam Chest 2 Views\|DISTINCT PROCEDURAL SERVICE	$7,807	$7,807	$5.33 – $3,563.91
Chest X-ray, 2 views: 10 of 69 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $709.02 BCBS [10301] — All BC PPO UM [44] Plans: $709.02 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $107.76 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $111.99 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $3,563.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $109.51 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $3,563.91 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $104.29 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $104.29 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $109.51
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: HC Lumbosacral Spine W Obliques 4 Views	$913	$913	$46.45 – $913
X-ray of the lower spine, at least 4 views: 10 of 59 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $595.28 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $913 BCBS [10301] — All BC HMO UM [11] Plans: $334.52 BCBS [10301] — All BC PPO UM [44] Plans: $334.52 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $913 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $129.45 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $135.25 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $589.52 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $131.56 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $913
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: HC MRI Lumbar Spine W/O Contrast	$3,763	$3,763	$151.98 – $3,763
MRI of the lower back (lumbar spine), without contrast: 10 of 54 insurance plan rates AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $3,763 BCBS [10301] — All BC HMO UM [11] Plans: $662.58 BCBS [10301] — All BC PPO UM [44] Plans: $662.58 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $3,763 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $299.10 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $307.44 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $2,816.84 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $303.97 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $3,763 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $2,816.84
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier 52 In the file: HC MRI Lumbar Spine W/O Contrast\|REDUCED SERVICES	$3,763	$3,763	$151.98 – $3,763
MRI of the lower back (lumbar spine), without contrast: 10 of 26 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $331.29 BCBS [10301] — All BC PPO UM [44] Plans: $331.29 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $299.10 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $307.44 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $303.97 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $289.49 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $289.49 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $303.97 FALLON CONNECTORCARE [10503] — All FALLON HMO UM [99] Plans: $891.83 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $303.97
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: HC CT Pelvis W Contrast	$3,044	$3,044	$210.21 – $3,044
CT scan of the pelvis, with contrast: 10 of 54 insurance plan rates AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $3,044 BCBS [10301] — All BC HMO UM [11] Plans: $579.75 BCBS [10301] — All BC PPO UM [44] Plans: $579.75 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $3,044 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $217.19 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $226.42 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $2,472.82 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $220.72 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $3,044 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $2,472.82
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: HC MRI Lower Extremity Any Jt W/O Contrast	$3,763	$3,763	$285.95 – $3,763
MRI of a leg joint (such as the knee), without contrast: 10 of 54 insurance plan rates AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $3,763 BCBS [10301] — All BC HMO UM [11] Plans: $662.58 BCBS [10301] — All BC PPO UM [44] Plans: $662.58 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $3,763 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $299.10 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $307.44 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $2,816.84 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $303.97 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $3,763 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $2,816.84
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: HC CT Abd & Pelvis W Contrast	$4,796	$4,796	$219.51 – $4,796
CT scan of the abdomen and pelvis, with contrast: 10 of 54 insurance plan rates AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $4,796 BCBS [10301] — All BC HMO UM [11] Plans: $1,108.94 BCBS [10301] — All BC PPO UM [44] Plans: $1,108.94 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $4,796 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $431.99 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $454.23 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,015.93 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $439.01 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $4,796 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,015.93
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: HC CT Abd & Pelvis W Contrast	$5,471.59	$5,471.59	$250.82 – $4,015.93
CT scan of the abdomen and pelvis, with contrast: 10 of 54 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $1,108.94 BCBS [10301] — All BC PPO UM [44] Plans: $1,108.94 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $431.99 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $454.23 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,015.93 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $439.01 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,015.93 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $418.11 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $418.11 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $439.01
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · modifier TC In the file: HC CT Abd & Pelvis W Contrast\|TECHNICAL COMPONENT	$8,405.36	$8,405.36	$250.82 – $4,015.93
CT scan of the abdomen and pelvis, with contrast: 10 of 33 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $1,108.94 BCBS [10301] — All BC PPO UM [44] Plans: $1,108.94 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,015.93 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,015.93 GRANTS [20507] — All TB GETCHELL [226] Plans: $250.82 HSNO/FREE CARE [10801] — All HSNO UM [68] Plans: $672.16 TUFTS [11201] — All TUFTS HMO UM [175] Plans: $1,178.24 TUFTS [11201] — All TUFTS PPO/CARELINK UM [176] Plans: $1,296.15 WELLPOINT [11112] — All WELLPOINT (UNICARE) UM [51] Plans: $953.30 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: 100% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: HC Abd US W Image Complete	$1,965	$1,965	$111.92 – $1,965
Ultrasound of the abdomen, complete: 10 of 54 insurance plan rates AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $1,965 BCBS [10301] — All BC HMO UM [11] Plans: $334.52 BCBS [10301] — All BC PPO UM [44] Plans: $334.52 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $1,965 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $129.45 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $135.25 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $826.52 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $131.56 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $1,965 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $826.52
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: HC US Preg Uterus >or=14wks Basic	$1,507	$1,507	$114.99 – $1,507
Pregnancy ultrasound (after the first trimester): 10 of 56 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $982.56 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $1,507 BCBS [10301] — All BC HMO UM [11] Plans: $334.52 BCBS [10301] — All BC PPO UM [44] Plans: $334.52 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $1,507 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $129.45 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $135.25 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $826.52 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $131.56 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $1,507
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: HC Transvaginal Ultrasound	$1,056	$1,056	$66.59 – $1,056
Transvaginal ultrasound: 10 of 56 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $688.51 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $1,056 BCBS [10301] — All BC HMO UM [11] Plans: $334.52 BCBS [10301] — All BC PPO UM [44] Plans: $334.52 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $1,056 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $129.45 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $135.25 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $826.52 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $131.56 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $1,056
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: HC Transvaginal Ultrasound	$2,496	$2,496	$96.43 – $826.52
Transvaginal ultrasound: 10 of 56 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $334.52 BCBS [10301] — All BC PPO UM [44] Plans: $334.52 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $129.45 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $135.25 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $826.52 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $131.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $826.52 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $125.29 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $125.29 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $131.56
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier 59 In the file: HC Transvaginal Ultrasound\|DISTINCT PROCEDURAL SERVICE	$2,131	$2,131	$96.43 – $826.52
Transvaginal ultrasound: 10 of 56 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $334.52 BCBS [10301] — All BC PPO UM [44] Plans: $334.52 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $129.45 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $135.25 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $826.52 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $131.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $826.52 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $125.29 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $125.29 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $131.56
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: HC Diagnostic Mammo Inc Computer Aided Detection Unilateral	$608	$608	$90.66 – $672.16
Diagnostic mammogram, one breast: 10 of 59 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $396.42 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $608 BCBS [10301] — All BC HMO UM [11] Plans: $435.50 BCBS [10301] — All BC PPO UM [44] Plans: $435.50 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $608 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $93.67 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $90.66 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $490.17 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $95.19 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $608
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: HC Mammo Scr to Dx Inc Computer Aided Detection Unilat	$608	$608	$90.66 – $672.16
Diagnostic mammogram, one breast: 10 of 59 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $396.42 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $608 BCBS [10301] — All BC HMO UM [11] Plans: $435.50 BCBS [10301] — All BC PPO UM [44] Plans: $435.50 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $608 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $93.67 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $90.66 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $490.17 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $95.19 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $608
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier TC\|RT In the file: HC Diagnostic Mammo Inc Computer Aided Detection Unilateral\|TECHNICAL COMPONENT\|RIGHT SIDE	$2,085	$2,085	$27.79 – $2,374.30
Diagnostic mammogram, one breast: 10 of 59 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $435.50 BCBS [10301] — All BC PPO UM [44] Plans: $435.50 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $93.67 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $90.66 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $95.19 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $160.47 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $90.66 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $95.19 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $95.19 HARVARD PILGRIM [10701] — All HARVARD PILGRIM BETH ISRAEL LAHEY UM [260] Plans: $368.05
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: HC Diagnostic Mammo Inc Computer Aided Detection Bilateral	$760	$760	$116.25 – $760
Diagnostic mammogram, both breasts: 10 of 59 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $495.52 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $760 BCBS [10301] — All BC HMO UM [11] Plans: $557.36 BCBS [10301] — All BC PPO UM [44] Plans: $557.36 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $760 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $120.11 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $116.25 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $612.71 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $122.06 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $760
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: HC Mammo Scr to Dx Inc Computer Aided Detection Bilat	$760	$760	$116.25 – $760
Diagnostic mammogram, both breasts: 10 of 58 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $495.52 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $760 BCBS [10301] — All BC HMO UM [11] Plans: $557.36 BCBS [10301] — All BC PPO UM [44] Plans: $557.36 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $760 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $120.11 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $116.25 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $612.71 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $122.06 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $760
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: HC Screen Mammo Bilat 2 View Ea Breast Inc Cad	$799	$799	$50.36 – $799
Screening mammogram, both breasts: 10 of 56 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $520.95 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $799 BCBS [10301] — All BC HMO UM [11] Plans: $460.54 BCBS [10301] — All BC PPO UM [44] Plans: $460.54 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $799 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $99.11 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $95.93 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $644.15 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $100.73 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $799
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier 52 In the file: HC Screen Mammo Bilat 2 View Ea Breast Inc Cad\|REDUCED SERVICES	$799	$799	$50.36 – $799
Screening mammogram, both breasts: rates for 8 insurance plans BCBS [10301] — All BC HMO UM [11] Plans: $230.27 BCBS [10301] — All BC PPO UM [44] Plans: $230.27 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $50.36 FALLON CONNECTORCARE [10503] — All FALLON HMO UM [99] Plans: $189.36 MGB MCR [10124] — All MGB MCR UM [316] Plans: $50.36 TUFTS [11201] — All TUFTS HMO UM [175] Plans: $212.50 TUFTS [11201] — All TUFTS PPO/CARELINK UM [176] Plans: $233.74 TUFTS MCR SUPP [20209] — All TUFTS MCR UM [241] Plans: $50.36
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier 52\|LT In the file: HC Screen Mammo Bilat 2 View Ea Breast Inc Cad\|REDUCED SERVICES\|LEFT SIDE	$799	$799	$50.36 – $799
Screening mammogram, both breasts: rates for 8 insurance plans BCBS [10301] — All BC HMO UM [11] Plans: $230.27 BCBS [10301] — All BC PPO UM [44] Plans: $230.27 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $50.36 FALLON CONNECTORCARE [10503] — All FALLON HMO UM [99] Plans: $189.36 MGB MCR [10124] — All MGB MCR UM [316] Plans: $50.36 TUFTS [11201] — All TUFTS HMO UM [175] Plans: $212.50 TUFTS [11201] — All TUFTS PPO/CARELINK UM [176] Plans: $233.74 TUFTS MCR SUPP [20209] — All TUFTS MCR UM [241] Plans: $50.36

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: HC L Hrt Cath W/Njx L Vntrclgr	$20,952	$20,952	$672.16 – $20,952
Left heart catheterization (diagnostic): 10 of 57 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $13,660.70 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $20,952 BCBS [10301] — All BC HMO UM [11] Plans: $5,968.14 BCBS [10301] — All BC PPO UM [44] Plans: $6,649.48 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4,014.28 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $4,090.88 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $13,632.60 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4,079.55 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $20,952 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $11,181
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: HC Comp Ep W/O Attempt Induction	$15,715	$15,715	$672.16 – $22,675.32
Heart rhythm study (electrophysiology evaluation): 10 of 57 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $10,246.18 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $15,715 BCBS [10301] — All BC HMO UM [11] Plans: $10,824.75 BCBS [10301] — All BC PPO UM [44] Plans: $12,060.53 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $9,657.82 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $9,651.13 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $22,675.32 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $9,814.86 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $15,715 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $22,675.32
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient In the file: HC Comp Ep Ablation Atrial Fib	$50,734	$50,734	$672.16 – $53,283.57
Heart rhythm study with ablation for atrial fibrillation: 10 of 58 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $33,078.57 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $50,734 BCBS [10301] — All BC HMO UM [11] Plans: $40,802.02 BCBS [10301] — All BC PPO UM [44] Plans: $45,460.09 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $50,734 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $32,364.83 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $31,202.06 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $40,901.75 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $32,891.09 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $50,734

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: HC Thera Ex 15 Min Pt	$230	$230	$23.10 – $672.16
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 58 insurance plan rates AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $230 BCBS [10301] — All BC HMO UM [11] Plans: $225.29 BCBS [10301] — All BC PPO UM [44] Plans: $251.01 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $230 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $31.34 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $25.35 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $94.35 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $31.85 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $230 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $94.35
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: HC Therapeutic Exercise 15 Min Ot	$230	$230	$23.10 – $672.16
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 57 insurance plan rates AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $230 BCBS [10301] — All BC HMO UM [11] Plans: $286.46 BCBS [10301] — All BC PPO UM [44] Plans: $319.16 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $230 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $31.34 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $25.35 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $94.35 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $31.85 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $230 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $94.35
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: HC Pt Evaluation Low Complexity	$454	$454	$86.24 – $672.16
Physical therapy evaluation (low complexity): 10 of 57 insurance plan rates AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $454 BCBS [10301] — All BC HMO UM [11] Plans: $267.82 BCBS [10301] — All BC PPO UM [44] Plans: $298.39 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $454 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $107.14 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $86.24 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $366.01 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $108.89 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $454 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $347.31
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier GP\|59 In the file: HC Pt Evaluation Low Complexity\|OP PT SERVICES\|DISTINCT PROCEDURAL SERVICE	$454	$454	$86.24 – $672.16
Physical therapy evaluation (low complexity): rates for 1 insurance plan HARVARD PILGRIM [10701] — All HARVARD PILGRIM HMO UM [113] Plans: $175.20
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: HC Pt Evaluation Moderate Complexity	$566	$566	$101.06 – $672.16
Physical therapy evaluation (moderate complexity): 10 of 57 insurance plan rates AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $566 BCBS [10301] — All BC HMO UM [11] Plans: $267.82 BCBS [10301] — All BC PPO UM [44] Plans: $298.39 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $566 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $107.14 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $101.06 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $456.31 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $108.89 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $566 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $432.99
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: HC Pt Evaluation High Complexity	$677	$677	$101.06 – $677
Physical therapy evaluation (high complexity): 10 of 57 insurance plan rates AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $677 BCBS [10301] — All BC HMO UM [11] Plans: $267.82 BCBS [10301] — All BC PPO UM [44] Plans: $298.39 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $677 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $107.14 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $101.06 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $545.80 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $108.89 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $677 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $517.91
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: HC PR Bh Psychotherapy W/ Pt 30 Min	$458	$458	$33.91 – $672.16
Psychotherapy, 30 minutes: 10 of 38 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $298.62 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $458 BCBS [10301] — All BC HMO UM [11] Plans: $270.86 BCBS [10301] — All BC PPO UM [44] Plans: $301.78 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $458 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $70.67 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $369.24 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $458 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $350.37 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $366.40
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: HC Bh Psychotherapy W/ Pt 30 Min	$296	$296	$33.91 – $672.16
Psychotherapy, 30 minutes: 10 of 38 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $192.99 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $296 BCBS [10301] — All BC HMO UM [11] Plans: $37.14 BCBS [10301] — All BC PPO UM [44] Plans: $41.38 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $296 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $70.67 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $238.64 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $296 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $226.44 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $236.80
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: HC Bh Psychotherapy W/ Pt 45 Min	$311	$311	$37.14 – $672.16
Psychotherapy, 45 minutes: 10 of 38 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $37.14 BCBS [10301] — All BC PPO UM [44] Plans: $41.38 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $93.39 FALLON MCAID CARELON HLTH [29] — All CARELON (FORMERLY BEACON BH) WELLSENSE/FALLON MCAID UM [: $242.62 HSNO/FREE CARE [10801] — All HSNO UM [68] Plans: $672.16 MASSHEALTH MCD MBHP [38] — All MBHP BEHAVIORAL HEALTH UM [17] Plans: $95.89 MEDICAID [20301] — All MEDICAID OF CT [28] Plans: $67.53 TUFTS [11201] — All TUFTS HMO UM [175] Plans: $42.97 TUFTS [11201] — All TUFTS PPO/CARELINK UM [176] Plans: $47.26 WELLPOINT [11112] — All WELLPOINT (UNICARE) UM [51] Plans: $245.96
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: HC PR Bh Psychotherapy W/ Pt 45 Min	$549	$549	$42.97 – $672.16
Psychotherapy, 45 minutes: 10 of 38 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $357.95 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $549 BCBS [10301] — All BC HMO UM [11] Plans: $270.86 BCBS [10301] — All BC PPO UM [44] Plans: $301.78 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $549 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $93.39 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $442.60 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $549 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $419.99 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $439.20
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: HC Bh Psychotherapy W/ Pt 45 Min	$311	$311	$42.97 – $672.16
Psychotherapy, 45 minutes: 10 of 38 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $202.77 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $311 BCBS [10301] — All BC HMO UM [11] Plans: $37.14 BCBS [10301] — All BC PPO UM [44] Plans: $41.38 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $311 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $93.39 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $250.73 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $311 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $237.92 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $248.80
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: HC Bh Psychotherapy W/ Pt 60 Min	$364	$364	$42.97 – $672.16
Psychotherapy, 60 minutes: 10 of 38 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $237.33 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $364 BCBS [10301] — All BC HMO UM [11] Plans: $37.14 BCBS [10301] — All BC PPO UM [44] Plans: $41.38 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $364 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $137.60 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $293.46 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $364 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $278.46 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $291.20
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: HC PR Bh Psychotherapy W/ Pt 60 Min	$607	$607	$42.97 – $672.16
Psychotherapy, 60 minutes: 10 of 38 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $395.76 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $607 BCBS [10301] — All BC HMO UM [11] Plans: $270.86 BCBS [10301] — All BC PPO UM [44] Plans: $301.78 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $607 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $137.60 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $489.36 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $607 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $464.36 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $485.60
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient In the file: HC PR Bh Family Therapy W/O Pt Present	$283	$283	$47.69 – $672.16
Family psychotherapy, without the patient: 10 of 38 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $184.52 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $283 BCBS [10301] — All BC HMO UM [11] Plans: $270.86 BCBS [10301] — All BC PPO UM [44] Plans: $301.78 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $283 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $100.82 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $228.15 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $283 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $216.50 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $226.40
Family psychotherapy, without the patient CPT 90846 · Inpatient or outpatient In the file: HC Bh Family Therapy W/O Pt Present	$283	$283	$47.69 – $672.16
Family psychotherapy, without the patient: 10 of 38 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $184.52 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $283 BCBS [10301] — All BC HMO UM [11] Plans: $270.86 BCBS [10301] — All BC PPO UM [44] Plans: $301.78 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $283 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $100.82 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $228.15 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $283 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $216.50 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $226.40
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: HC PR Bh Family Therapy W Pt Present	$283	$283	$47.69 – $672.16
Family psychotherapy, with the patient: 10 of 38 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $184.52 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $283 BCBS [10301] — All BC HMO UM [11] Plans: $270.86 BCBS [10301] — All BC PPO UM [44] Plans: $301.78 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $283 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $104.62 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $228.15 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $283 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $216.50 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $226.40
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: HC Bh Family Therapy W Pt Present	$247	$247	$47.69 – $672.16
Family psychotherapy, with the patient: 10 of 38 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $161.04 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $247 BCBS [10301] — All BC HMO UM [11] Plans: $37.14 BCBS [10301] — All BC PPO UM [44] Plans: $41.38 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $247 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $104.62 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $199.13 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $247 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $188.96 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $197.60
Group psychotherapy CPT 90853 · Inpatient or outpatient In the file: HC Bh Php/Iop Group Therapy	$174	$174	$24.12 – $672.16
Group psychotherapy: 10 of 45 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $113.45 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $174 BCBS [10301] — All BC HMO UM [11] Plans: $162.23 BCBS [10301] — All BC PPO UM [44] Plans: $180.75 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $174 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $117.65 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $140.28 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $69.60 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $174 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $133.11
Group psychotherapy CPT 90853 · Inpatient or outpatient In the file: HC PR Bh Group Therapy	$222	$222	$24.12 – $672.16
Group psychotherapy: 10 of 38 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $144.74 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $222 BCBS [10301] — All BC HMO UM [11] Plans: $162.23 BCBS [10301] — All BC PPO UM [44] Plans: $180.75 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $222 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $117.65 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $178.98 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $222 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $169.83 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $177.60

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: HC Exc Breast Cyst/Other Lesions	$16,319.58	$16,319.58	$6.52 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $17,714.32
Removal of breast growth (open surgery): 10 of 59 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $6,440.54 BCBS [10301] — All BC PPO UM [44] Plans: $6,440.54 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4,848.23 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $4,870.37 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $10,944.12 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4,927.06 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $10,944.12 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $4,692.44 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $4,692.44 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $4,927.06
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: HC Exc Breast Cyst/Other Lesions	$4,628	$4,628	$672.16 – $8,857.16
Removal of breast growth (open surgery): 10 of 58 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $3,017.46 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $4,628 BCBS [10301] — All BC HMO UM [11] Plans: $3,220.27 BCBS [10301] — All BC PPO UM [44] Plans: $3,220.27 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $4,628 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4,908.24 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $4,870.37 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $5,472.06 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4,988.05 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $4,628
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · modifier 51\|RT In the file: HC Exc Breast Cyst/Other Lesions\|MULTIPLE PROCEDURES\|RIGHT SIDE	$17,482.55	$17,482.55	$6.52 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $17,714.32
Removal of breast growth (open surgery): 10 of 68 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $3,220.27 BCBS [10301] — All BC PPO UM [44] Plans: $3,220.27 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4,848.23 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $4,870.37 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $5,472.06 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4,927.06 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $5,472.06 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $4,692.44 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $4,692.44 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $4,927.06
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Total Hip Arthroplasty	$74,925.45	$74,925.45	$1.44 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $35,083.13
Total hip replacement: 10 of 62 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $10,154.40 BCBS [10301] — All BC PPO UM [44] Plans: $10,154.40 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $15,897.32 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $16,365.01 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $35,083.13 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $16,155.81 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $28,774 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $15,386.48 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $15,386.48 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $16,155.81
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier LT In the file: Total Hip Arthroplasty\|LEFT SIDE	$67,724.50	$67,724.50	$1.44 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $35,083.13
Total hip replacement: 10 of 62 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $10,154.40 BCBS [10301] — All BC PPO UM [44] Plans: $10,154.40 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $15,897.32 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $16,365.01 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $35,083.13 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $16,155.81 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $28,774 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $15,386.48 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $15,386.48 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $16,155.81
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · modifier RT In the file: Total Hip Arthroplasty\|RIGHT SIDE	$66,600.46	$66,600.46	$1.44 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $35,083.13
Total hip replacement: 10 of 62 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $10,154.40 BCBS [10301] — All BC PPO UM [44] Plans: $10,154.40 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $15,897.32 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $16,365.01 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $35,083.13 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $16,155.81 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $28,774 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $15,386.48 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $15,386.48 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $16,155.81
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier LT In the file: Total Knee Arthroplasty\|LEFT SIDE	$60,152.03	$60,152.03	$7.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $31,035.17
Total knee replacement: 10 of 62 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $12,251.93 BCBS [10301] — All BC PPO UM [44] Plans: $12,251.93 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $15,897.32 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $16,365.01 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $31,035.17 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $16,155.81 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $25,454 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $15,386.48 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $15,386.48 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $16,155.81
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · modifier RT In the file: Total Knee Arthroplasty\|RIGHT SIDE	$60,726.08	$60,726.08	$7.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $31,035.17
Total knee replacement: 10 of 62 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $12,251.93 BCBS [10301] — All BC PPO UM [44] Plans: $12,251.93 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $15,897.32 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $16,365.01 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $31,035.17 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $16,155.81 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $25,454 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $15,386.48 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $15,386.48 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $16,155.81
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Shldr Arthroscop,Part Acromioplas	$31,822.72	$31,822.72	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $14,792.22
Shoulder arthroscopy: shaving of shoulder bone: 10 of 57 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $6,517.81 BCBS [10301] — All BC PPO UM [44] Plans: $6,517.81 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $8,984.90 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $9,085.94 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $7,693.56 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $9,131 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $7,693.56 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $8,696.19 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $8,696.19 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $9,131
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier 59\|RT In the file: Shldr Arthroscop,Part Acromioplas\|DISTINCT PROCEDURAL SERVICE\|RIGHT SIDE	$124,671.88	$124,671.88	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $14,792.22
Shoulder arthroscopy: shaving of shoulder bone: 10 of 59 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $6,517.81 BCBS [10301] — All BC PPO UM [44] Plans: $6,517.81 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $8,984.90 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $9,085.94 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $14,239.79 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $9,131 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $14,239.79 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $8,696.19 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $8,696.19 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $9,131
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · modifier LT In the file: Shldr Arthroscop,Part Acromioplas\|LEFT SIDE	$59,338.99	$59,338.99	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $14,792.22
Shoulder arthroscopy: shaving of shoulder bone: 10 of 58 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $6,517.81 BCBS [10301] — All BC PPO UM [44] Plans: $6,517.81 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $8,984.90 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $9,085.94 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $5,472.06 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $9,131 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $5,472.06 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $8,696.19 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $8,696.19 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $9,131
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier LT\|59 In the file: PR Arthro, Knee, Surg; With Menis (Med or Lat) Incl Deb/Shav When Perf\|LEFT SIDE\|DISTINCT PROCEDURAL SERVICE	$37,935.15	$37,935.15	$7.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $26,172.41
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 61 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $2,999.94 BCBS [10301] — All BC PPO UM [44] Plans: $2,999.94 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4,051.51 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $4,126.74 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $6,732.78 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4,117.39 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $6,732.78 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $3,921.32 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $3,921.32 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $4,117.39
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier 51\|LT In the file: PR Arthro, Knee, Surg; With Menis (Med or Lat) Incl Deb/Shav When Perf\|MULTIPLE PROCEDURES\|LEFT SIDE	$42,943.33	$42,943.33	$7.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $26,172.41
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 58 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $2,999.94 BCBS [10301] — All BC PPO UM [44] Plans: $2,999.94 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $8,984.90 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $9,085.94 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $6,732.78 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $9,131 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $6,732.78 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $8,696.19 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $8,696.19 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $9,131
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · modifier 51\|RT In the file: PR Arthro, Knee, Surg; With Menis (Med or Lat) Incl Deb/Shav When Perf\|MULTIPLE PROCEDURES\|RIGHT SIDE	$35,780.22	$35,780.22	$7.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $26,172.41
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 58 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $2,999.94 BCBS [10301] — All BC PPO UM [44] Plans: $2,999.94 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $8,984.90 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $9,085.94 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $6,732.78 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $9,131 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $6,732.78 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $8,696.19 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $8,696.19 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $9,131
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Remove Tonsils/Adenoids,<12 Y/O	$14,601.63	$14,601.63	$25.11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,067.92
Removal of tonsils and adenoids (under age 12): 10 of 59 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $5,059.36 BCBS [10301] — All BC PPO UM [44] Plans: $5,059.36 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $7,330.15 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $7,523.99 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $5,472.06 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $7,449.33 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $5,472.06 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $7,094.60 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $7,094.60 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $7,449.33
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · modifier 51 In the file: Remove Tonsils/Adenoids,<12 Y/O\|MULTIPLE PROCEDURES	$16,961.61	$16,961.61	$25.11 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,067.92
Removal of tonsils and adenoids (under age 12): 10 of 59 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $5,059.36 BCBS [10301] — All BC PPO UM [44] Plans: $5,059.36 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $7,330.15 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $7,523.99 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $5,472.06 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $7,449.33 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $5,472.06 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $7,094.60 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $7,094.60 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $7,449.33
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: HC Egd Flexible Transoral Diagnostic	$6,733.18	$6,733.18	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,563.91
Upper GI endoscopy (diagnostic): 10 of 67 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $870.88 BCBS [10301] — All BC PPO UM [44] Plans: $870.88 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,123.06 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,192.46 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $3,563.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,141.32 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $3,563.91 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,086.97 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,086.97 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,141.32
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: HC Egd Flexible Transoral Diagnostic	$3,236	$3,236	$435.44 – $3,563.91
Upper GI endoscopy (diagnostic): 10 of 58 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $2,109.87 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $3,236 BCBS [10301] — All BC HMO UM [11] Plans: $870.88 BCBS [10301] — All BC PPO UM [44] Plans: $870.88 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $3,236 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,123.06 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,192.46 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $3,563.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,141.32 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $3,236
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · modifier 52 In the file: HC Egd Flexible Transoral Diagnostic\|REDUCED SERVICES	$6,618.83	$6,618.83	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $3,563.91
Upper GI endoscopy (diagnostic): 10 of 60 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $435.44 BCBS [10301] — All BC PPO UM [44] Plans: $435.44 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,123.06 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,192.46 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $3,563.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,141.32 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $3,563.91 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,086.97 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,086.97 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,141.32
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: HC Esophagogastroduodenoscopy W/Biopsy	$8,455.98	$8,455.98	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,770.98
Upper GI endoscopy with biopsy: 10 of 68 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $870.88 BCBS [10301] — All BC PPO UM [44] Plans: $870.88 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,123.06 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,192.46 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,141.32 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,086.97 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,086.97 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,141.32
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: HC Esophagogastroduodenoscopy W/Biopsy	$3,455	$3,455	$435.44 – $4,770.98
Upper GI endoscopy with biopsy: 10 of 58 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $2,252.66 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $3,455 BCBS [10301] — All BC HMO UM [11] Plans: $870.88 BCBS [10301] — All BC PPO UM [44] Plans: $870.88 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $3,455 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,123.06 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,192.46 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,141.32 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $3,455
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · modifier 51\|59 In the file: HC Esophagogastroduodenoscopy W/Biopsy\|MULTIPLE PROCEDURES\|DISTINCT PROCEDURAL SERVICE	$15,667.70	$15,667.70	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,770.98
Upper GI endoscopy with biopsy: 10 of 60 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $870.88 BCBS [10301] — All BC PPO UM [44] Plans: $870.88 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,123.06 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,192.46 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,141.32 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,086.97 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,086.97 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,141.32
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy	$7,401.13	$7,401.13	$55.58 – $4,770.98
Colonoscopy (diagnostic): 10 of 58 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $851.82 BCBS [10301] — All BC PPO UM [44] Plans: $851.82 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,151.51 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,159.58 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,170.23 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,114.51 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,114.51 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,170.23
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: Colonoscopy	$3,455	$3,455	$425.91 – $4,770.98
Colonoscopy (diagnostic): 10 of 58 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $2,252.66 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $3,455 BCBS [10301] — All BC HMO UM [11] Plans: $851.82 BCBS [10301] — All BC PPO UM [44] Plans: $851.82 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $3,455 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,151.51 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,159.58 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,170.23 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $3,455
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · modifier 51 In the file: Colonoscopy\|MULTIPLE PROCEDURES	$12,059.78	$12,059.78	$55.58 – $4,770.98
Colonoscopy (diagnostic): 10 of 59 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $790.91 BCBS [10301] — All BC PPO UM [44] Plans: $881.21 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,151.51 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,159.58 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,170.23 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,114.51 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,114.51 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,170.23
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: HC Colonoscopy Bey Spl Flx W Biopsy	$8,652.98	$8,652.98	$1.98 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,770.98
Colonoscopy with biopsy: 10 of 68 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $1,120.45 BCBS [10301] — All BC PPO UM [44] Plans: $1,120.45 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,481.72 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,499.64 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,505.82 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,434.11 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,434.11 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,505.82
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: HC Colonoscopy Bey Spl Flx W Biopsy	$3,455	$3,455	$672.16 – $4,770.98
Colonoscopy with biopsy: 10 of 58 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $2,252.66 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $3,455 BCBS [10301] — All BC HMO UM [11] Plans: $1,120.45 BCBS [10301] — All BC PPO UM [44] Plans: $1,120.45 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $3,455 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,481.72 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,499.64 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,505.82 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $3,455
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · modifier 52\|59 In the file: HC Colonoscopy Bey Spl Flx W Biopsy\|REDUCED SERVICES\|DISTINCT PROCEDURAL SERVICE	$26,227.86	$26,227.86	$1.98 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $4,770.98
Colonoscopy with biopsy: 10 of 67 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $1,120.45 BCBS [10301] — All BC PPO UM [44] Plans: $1,120.45 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,481.72 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,499.64 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,505.82 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,434.11 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,434.11 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,505.82
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: HC Colonoscopy Bey Spl Flx W Plp Rm Snar	$10,917.45	$10,917.45	$27.79 – $5,658.35
Colonoscopy with removal of polyps (snare): 10 of 58 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $1,120.45 BCBS [10301] — All BC PPO UM [44] Plans: $1,120.45 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,481.72 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,499.64 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,505.82 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,434.11 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,434.11 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,505.82
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: HC Colonoscopy Bey Spl Flx W Plp Rm Snar	$3,455	$3,455	$672.16 – $4,770.98
Colonoscopy with removal of polyps (snare): 10 of 58 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $2,252.66 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $3,455 BCBS [10301] — All BC HMO UM [11] Plans: $1,120.45 BCBS [10301] — All BC PPO UM [44] Plans: $1,120.45 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $3,455 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,481.72 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,499.64 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,505.82 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $3,455
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · modifier 52 In the file: HC Colonoscopy Bey Spl Flx W Plp Rm Snar\|REDUCED SERVICES	$9,526.28	$9,526.28	$27.79 – $5,658.35
Colonoscopy with removal of polyps (snare): 10 of 59 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $1,120.45 BCBS [10301] — All BC PPO UM [44] Plans: $1,120.45 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,481.72 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,499.64 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,505.82 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,434.11 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,434.11 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,505.82
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient In the file: HC Colonoscopy W Endosc Usexam	$3,204	$3,204	$979.79 – $4,770.98
Ultrasound of the lower bowel by endoscope: 10 of 57 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $2,089.01 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $3,204 BCBS [10301] — All BC HMO UM [11] Plans: $1,120.45 BCBS [10301] — All BC PPO UM [44] Plans: $1,120.45 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,481.72 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,499.64 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,505.82 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $3,204 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient · modifier 59 In the file: HC Colonoscopy W Endosc Usexam\|DISTINCT PROCEDURAL SERVICE	$3,204	$3,204	$979.79 – $4,770.98
Ultrasound of the lower bowel by endoscope: rates for 1 insurance plan BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $3,204
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: HC Screening Colonoscopy Low Risk	$6,935.39	$6,935.39	$6.52 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,659.47
Screening colonoscopy (not high risk): 10 of 68 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $851.82 BCBS [10301] — All BC PPO UM [44] Plans: $851.82 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,151.51 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,159.58 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,170.23 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,114.51 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,114.51 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,170.23
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: HC Screening Colonoscopy Low Risk	$3,458	$3,458	$585.12 – $4,770.98
Screening colonoscopy (not high risk): 10 of 58 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $2,254.62 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $3,458 BCBS [10301] — All BC HMO UM [11] Plans: $851.82 BCBS [10301] — All BC PPO UM [44] Plans: $851.82 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $3,458 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,151.51 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,159.58 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,170.23 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $3,458
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · modifier 59 In the file: HC Screening Colonoscopy Low Risk\|DISTINCT PROCEDURAL SERVICE	$11,633.57	$11,633.57	$6.52 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $5,659.47
Screening colonoscopy (not high risk): 10 of 57 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $1,696.30 BCBS [10301] — All BC PPO UM [44] Plans: $1,696.30 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $2,376.06 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $2,412.74 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $5,472.06 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $2,414.70 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $5,472.06 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $2,299.71 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $2,299.71 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $2,414.70
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Lap,Cholecystectomy	$25,750.17	$25,750.17	$7.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,324.16
Gallbladder removal by laparoscope: 10 of 58 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $5,255.62 BCBS [10301] — All BC PPO UM [44] Plans: $5,255.62 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $7,485.79 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $7,420.59 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $7,653.56 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $7,607.51 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $6,310 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $7,245.25 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $7,245.25 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $7,607.51
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient In the file: HC Laparoscopic Cholecystectomy	$14,352	$14,352	$672.16 – $14,352
Gallbladder removal by laparoscope: 10 of 39 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $9,357.50 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $14,352 BCBS [10301] — All BC HMO UM [11] Plans: $5,255.62 BCBS [10301] — All BC PPO UM [44] Plans: $5,255.62 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $7,653.56 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $14,352 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $6,310 EVERNORTH BEHAVIORAL HEALTH [27] — All EVERNORTH (FORMERLY CIGNA) BEHAVIORAL HEALTH UM [18] Pla: $11,481.60 FALLON MCAID CARELON HLTH [29] — All CARELON (FORMERLY BEACON BH) WELLSENSE/FALLON MCAID UM [: $14,352 FIRST HEALTH NETWORK [11120] — All COVENTRY (FIRST HEALTH) [83] Plans: $10,764
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · modifier 52 In the file: Lap,Cholecystectomy\|REDUCED SERVICES	$32,807.55	$32,807.55	$7.46 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,324.16
Gallbladder removal by laparoscope: 10 of 62 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $5,255.62 BCBS [10301] — All BC PPO UM [44] Plans: $5,255.62 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $7,485.79 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $7,420.59 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $7,653.56 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $7,607.51 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $6,310 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $7,245.25 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $7,245.25 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $7,607.51
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Repair Ing Hernia,5+Y/O,Reducibl	$21,737.45	$21,737.45	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,375.88
Groin (inguinal) hernia repair, age 5 or older: 10 of 67 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $3,370.43 BCBS [10301] — All BC PPO UM [44] Plans: $3,370.43 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4,433.38 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $4,488.53 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $6,732.78 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4,505.47 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $6,732.78 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $4,290.92 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $4,290.92 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $4,505.47
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier LT In the file: Repair Ing Hernia,5+Y/O,Reducibl\|LEFT SIDE	$16,858.51	$16,858.51	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,375.88
Groin (inguinal) hernia repair, age 5 or older: 10 of 60 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $3,370.43 BCBS [10301] — All BC PPO UM [44] Plans: $3,370.43 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4,433.38 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $4,488.53 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $6,732.78 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4,505.47 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $6,732.78 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $4,290.92 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $4,290.92 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $4,505.47
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · modifier 50 In the file: Repair Ing Hernia,5+Y/O,Reducibl\|BILATERAL PROCEDURE	$16,511.76	$16,511.76	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $12,375.88
Groin (inguinal) hernia repair, age 5 or older: 10 of 58 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $5,055.65 BCBS [10301] — All BC PPO UM [44] Plans: $5,055.65 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $7,517.20 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $7,571.24 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $6,732.78 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $7,639.43 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $6,732.78 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $7,275.65 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $7,275.65 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $7,639.43
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: HC Biopsy of Prostate	$25,644.65	$25,644.65	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $7,185.88
Prostate biopsy: 10 of 59 insurance plan rates BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $443.84 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $2,605.45 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $429.58 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $429.58 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $451.06 HARVARD PILGRIM [10701] — All HARVARD PILGRIM BETH ISRAEL LAHEY UM [260] Plans: $1,892.12 HARVARD PILGRIM [10701] — All HARVARD PILGRIM HMO UM [113] Plans: $1,574.02 HARVARD PILGRIM [10701] — All HARVARD PILGRIM PPO UM [114] Plans: $1,809.85
Prostate biopsy CPT 55700 · Inpatient or outpatient In the file: HC Biopsy of Prostate	$2,097	$2,097	$493.08 – $4,770.98
Prostate biopsy: 10 of 45 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $1,367.24 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $2,097 BCBS [10301] — All BC HMO UM [11] Plans: $1,624.34 BCBS [10301] — All BC PPO UM [44] Plans: $1,682.63 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $2,097 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $2,605.45 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $838.80 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $2,097 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · modifier 51 In the file: HC Biopsy of Prostate\|MULTIPLE PROCEDURES	$30,813.72	$30,813.72	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $7,185.88
Prostate biopsy: 10 of 61 insurance plan rates BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4,364.76 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $4,386.66 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4,435.73 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $4,224.50 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $4,224.50 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $4,435.73 FALLON CONNECTORCARE [10503] — All FALLON HMO UM [99] Plans: $506 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $4,435.73
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy,W/Endo Bx	$21,608.66	$21,608.66	$6.52 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $10,197.79
Hysteroscopy with biopsy of the uterus lining: 10 of 67 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $2,700.25 BCBS [10301] — All BC PPO UM [44] Plans: $2,700.25 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4,008.33 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $4,043.97 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $5,472.06 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4,073.50 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $5,472.06 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $3,879.52 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $3,879.52 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $4,073.50
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier 52 In the file: Hysteroscopy,W/Endo Bx\|REDUCED SERVICES	$13,318.84	$13,318.84	$6.52 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $10,197.79
Hysteroscopy with biopsy of the uterus lining: 10 of 68 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $2,700.25 BCBS [10301] — All BC PPO UM [44] Plans: $2,700.25 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $4,008.33 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $4,043.97 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $5,472.06 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $4,073.50 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $5,472.06 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $3,879.52 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $3,879.52 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $4,073.50
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · modifier 51 In the file: Hysteroscopy,W/Endo Bx\|MULTIPLE PROCEDURES	$44,199.12	$44,199.12	$6.52 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $10,197.79
Hysteroscopy with biopsy of the uterus lining: 10 of 67 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $2,700.25 BCBS [10301] — All BC PPO UM [44] Plans: $2,700.25 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $6,194.21 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $6,278.56 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $5,472.06 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $6,294.93 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $5,472.06 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $5,995.17 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $5,995.17 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $6,294.93
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: HC Injection Interlaminar Epi Lumbar/Sacral W /Img Guide	$2,530	$2,530	$444.13 – $2,530
Spinal injection, lower back (epidural), with imaging guidance: 10 of 56 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $1,649.56 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $2,530 BCBS [10301] — All BC HMO UM [11] Plans: $684.77 BCBS [10301] — All BC PPO UM [44] Plans: $684.77 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $2,530 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $874.05 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $880.80 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $888.26 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $2,530 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $845.96
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: HC Injection Interlaminar Epi Lumbar/Sacral W /Img Guide	$2,992.13	$2,992.13	$26.84 – $2,374.30
Spinal injection, lower back (epidural), with imaging guidance: 10 of 55 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $684.77 BCBS [10301] — All BC PPO UM [44] Plans: $684.77 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $874.05 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $880.80 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $888.26 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $845.96 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $845.96 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $888.26 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $888.26 HARVARD PILGRIM [10701] — All HARVARD PILGRIM BETH ISRAEL LAHEY UM [260] Plans: $598.81
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · modifier 50 In the file: HC Injection Interlaminar Epi Lumbar/Sacral W /Img Guide\|BILATERAL PROCEDURE	$2,892.88	$2,892.88	$26.84 – $2,374.30
Spinal injection, lower back (epidural), with imaging guidance: 10 of 57 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $684.77 BCBS [10301] — All BC PPO UM [44] Plans: $684.77 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $874.05 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $880.80 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $888.26 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $845.96 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $845.96 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $888.26 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $888.26 HARVARD PILGRIM [10701] — All HARVARD PILGRIM BETH ISRAEL LAHEY UM [260] Plans: $598.81
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: HC Inj Anes/Strd Lbr/Sac 1 Level	$2,615	$2,615	$315.26 – $3,563.91
Nerve root injection, lower back, with imaging guidance: 10 of 58 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $1,704.98 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $2,615 BCBS [10301] — All BC HMO UM [11] Plans: $874.64 BCBS [10301] — All BC PPO UM [44] Plans: $874.64 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $2,615 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,095.19 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,132.34 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $3,563.91 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,112.99 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $2,615
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · modifier 50 In the file: HC Inj Anes/Strd Lbr/Sac 1 Level\|BILATERAL PROCEDURE	$2,615	$2,615	$315.26 – $3,563.91
Nerve root injection, lower back, with imaging guidance: 10 of 29 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $1,311.96 BCBS [10301] — All BC PPO UM [44] Plans: $1,311.96 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,095.19 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,132.34 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,112.99 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,059.99 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,059.99 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,112.99 FALLON CONNECTORCARE [10503] — All FALLON HMO UM [99] Plans: $1,859.27 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $1,112.99
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · modifier 50\|59 In the file: HC Inj Anes/Strd Lbr/Sac 1 Level\|BILATERAL PROCEDURE\|DISTINCT PROCEDURAL SERVICE	$2,615	$2,615	$315.26 – $3,563.91
Nerve root injection, lower back, with imaging guidance: 10 of 29 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $1,311.96 BCBS [10301] — All BC PPO UM [44] Plans: $1,311.96 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $1,095.19 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $1,132.34 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $1,112.99 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $1,059.99 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $1,059.99 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $1,112.99 FALLON CONNECTORCARE [10503] — All FALLON HMO UM [99] Plans: $1,859.27 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $1,112.99
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: HC Carpal Tunnel Surgery Median Nerve	$5,179.38	$5,179.38	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $26,172.41
Carpal tunnel release: 10 of 58 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $1,865.69 BCBS [10301] — All BC PPO UM [44] Plans: $1,865.69 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $2,417.93 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $2,483.68 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $2,457.25 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $2,340.24 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $2,340.24 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $2,457.25
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: HC Carpal Tunnel Surgery Median Nerve	$5,099	$5,099	$672.16 – $5,659.47
Carpal tunnel release: 10 of 58 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $3,324.55 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $5,099 BCBS [10301] — All BC HMO UM [11] Plans: $1,865.69 BCBS [10301] — All BC PPO UM [44] Plans: $1,865.69 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $5,099 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $2,417.93 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $2,483.68 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $2,457.25 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $5,099
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · modifier RT In the file: HC Carpal Tunnel Surgery Median Nerve\|RIGHT SIDE	$8,481.54	$8,481.54	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $26,172.41
Carpal tunnel release: 10 of 68 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $1,865.69 BCBS [10301] — All BC PPO UM [44] Plans: $1,865.69 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $2,417.93 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $2,483.68 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $2,457.25 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $2,340.24 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $2,340.24 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $2,457.25
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient In the file: HC Capsulotomy	$5,196	$5,196	$232.38 – $5,196
Laser treatment of clouding after cataract surgery: 10 of 58 insurance plan rates AETNA [11101] — All AETNA UM [92] Plans: $3,387.79 AUTOMOBILE [10401] — All CATCH ALL @ 100% [217] Plans: $5,196 BCBS [10301] — All BC HMO UM [11] Plans: $567.41 BCBS [10301] — All BC PPO UM [44] Plans: $567.41 BCBS MA PPO OPTUM BH [63] — All OPTUM BEHAVIORAL HEALTH (UBH) UM [246] Plans: $5,196 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $681.03 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $697.75 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $692.10 CONNECTICARE [11105] — All CATCH ALL @ 100% [217] Plans: $5,196
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient · modifier 50 In the file: HC Capsulotomy\|BILATERAL PROCEDURE	$5,196	$5,196	$232.38 – $5,196
Laser treatment of clouding after cataract surgery: 10 of 31 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $851.12 BCBS [10301] — All BC PPO UM [44] Plans: $851.12 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $681.03 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $697.75 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $4,770.98 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $692.10 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $4,770.98 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $659.14 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $659.14 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $692.10
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Remv Cataract Extracap,Insert Lens	$9,170.17	$9,170.17	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $11,223.33
Cataract removal with lens implant: 10 of 59 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $2,035.62 BCBS [10301] — All BC PPO UM [44] Plans: $2,268.02 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $2,857.63 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $2,900.81 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $11,223.33 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $2,904.10 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $11,223.33 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $2,765.81 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $2,765.81 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $2,904.10
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · modifier 59\|LT In the file: Remv Cataract Extracap,Insert Lens\|DISTINCT PROCEDURAL SERVICE\|LEFT SIDE	$39,064.81	$39,064.81	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $11,223.33
Cataract removal with lens implant: 10 of 67 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $2,192.38 BCBS [10301] — All BC PPO UM [44] Plans: $2,192.38 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $6,589.03 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $6,562.52 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $11,223.33 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $6,696.17 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $11,223.33 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $6,377.30 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $6,377.30 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $6,696.17
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · modifier 59\|RT In the file: Remv Cataract Extracap,Insert Lens\|DISTINCT PROCEDURAL SERVICE\|RIGHT SIDE	$45,254.47	$45,254.47	$2.89 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $11,223.33
Cataract removal with lens implant: 10 of 60 insurance plan rates BCBS [10301] — All BC HMO UM [11] Plans: $2,192.38 BCBS [10301] — All BC PPO UM [44] Plans: $2,192.38 BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $6,589.03 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $6,562.52 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $11,223.33 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $6,696.17 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $11,223.33 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $6,377.30 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $6,377.30 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $6,696.17

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) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	$438,302.83	$438,302.83	$758.07 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $209,414.89
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 47 insurance plan rates BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $93,681.45 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $186,381 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $95,047.86 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $186,381 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $137,073.65 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $90,521.77 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $95,047.86 FALLON MCAID CARELON HLTH [29] — All CARELON (FORMERLY BEACON BH) WELLSENSE/FALLON MCAID UM [: $2,064.74 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $95,047.86 HARVARD PILGRIM MCR SUPP [20203] — All HARVARD PILGRIM MCR UM [140] Plans: $95,047.86
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	$78,252.37	$78,252.37	$758.07 – $44,691
Hip or knee replacement (major joint of the leg), without major complications: 10 of 47 insurance plan rates BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $19,033.80 CHAMPVA [11001] — All TRICARE / CHAMPVA UM [164] Plans: $19,833.39 CIGNA HEALTH PLAN [11104] — All CIGNA UM [78] Plans: $44,691 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $19,312.36 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE COUNTY UM [160] Plans: $44,691 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $26,779.57 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $18,392.72 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $19,312.36 FALLON CONNECTORCARE [10503] — All FALLON HMO UM [99] Plans: $41,920.78 FALLON MCAID CARELON HLTH [29] — All CARELON (FORMERLY BEACON BH) WELLSENSE/FALLON MCAID UM [: $2,064.74
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	$68,525.98	$68,525.98	$758.07 – $53,056.77
Neck (cervical) spinal fusion, without complications: 10 of 43 insurance plan rates BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $23,903.92 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $24,253.46 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $33,623.96 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $23,098.53 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $24,253.46 FALLON CONNECTORCARE [10503] — All FALLON HMO UM [99] Plans: $53,056.77 FALLON MCAID CARELON HLTH [29] — All CARELON (FORMERLY BEACON BH) WELLSENSE/FALLON MCAID UM [: $2,064.74 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $24,253.46 HARVARD PILGRIM MCR SUPP [20203] — All HARVARD PILGRIM MCR UM [140] Plans: $24,253.46 HSNO/FREE CARE [10801] — All HSNO UM [68] Plans: $30,047.82
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	$49,977.94	$49,977.94	$758.07 – $26,964.13
Uterus and ovary surgery (not for cancer), without complications: 10 of 44 insurance plan rates BCBS MCR SUPP [20201] — All BC MCR UM [63] Plans: $12,492.78 COMMONWEALTH CARE MCR [10115] — All ONE CARE UM [144] Plans: $12,676.02 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE FORT DEVENS UM [161] Plans: $17,025.03 CORRECTIONAL CARE [11003] — All CORRECTIONAL CARE STATE UM [94] Plans: $12,072.40 ETERNALHEALTH MCR REPLACE [10116] — All MEDICARE ADV AT 105% UM [136] Plans: $12,676.02 FALLON CONNECTORCARE [10503] — All FALLON HMO UM [99] Plans: $26,964.13 FALLON MCAID CARELON HLTH [29] — All CARELON (FORMERLY BEACON BH) WELLSENSE/FALLON MCAID UM [: $2,064.74 FALLON MCR [10105] — All FALLON SENIOR UM [137] Plans: $12,676.02 HARVARD PILGRIM MCR SUPP [20203] — All HARVARD PILGRIM MCR UM [140] Plans: $12,676.02 HNE [11108] — All HEALTH NEW ENGLAND UM [82] Plans: $2,132

Source: UMass Memorial Medical Center/University Campus’s standard charges file (d1477x5i4cdpk9.cloudfront.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 26, 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	Acute Care Hospital
Address	55 Lake Avenue North, Worcester, MA 01655
County	Worcester County
State	Massachusetts
Phone	(508) 334‑1000
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	3 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	220163
Name in Medicare records	UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS
Profile level	Medicare data + hospital website
Official website	ummhealth.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.

UMass Memorial Medical Center - University Campus — ummhealth.org
UMass Memorial Medical Center - University Campus Emergency Department — ummhealth.org