Cost of a ER Visit (High) Visit
in Massachusetts
Reviewed by Momentary Medical Group West PC
Massachusetts's robust healthcare infrastructure, anchored by world-renowned teaching hospitals and academic medical centers, supports extensive emergency care capacity across the state. For high-severity emergency visits, patients in Massachusetts typically encounter negotiated insurance rates ranging from $80 to $428, with a median cost of $97.50 based on transparency data from nearly 2,000 active emergency providers. The state's concentration of major medical centers in Boston and Springfield, combined with strong rural hospital networks, means patients can browse emergency care options throughout Massachusetts with varying cost structures.
Average
$202
Median
$98
Lowest
$80
Highest
$428
Providers
1,941
7% above national average
Compare Similar Procedures
How does er visit (high severity) compare to related procedures in Massachusetts?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| ER Visit (Low Severity) Emergency department visit, low severity | 99283 | $40 | $40 | $206 | 1,959 |
| ER Visit (Moderate Severity) Emergency department visit, moderate severity | 99284 | $62 | $80 | $368 | 2,064 |
Important: These are cost estimates only — not a quote and not medical advice.
The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 99285 — Emergency department visit, high severity). They represent what a patient might pay without insurance.
Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.
This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.
Where this data comes from & what CPT 99285 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 99285 (Emergency department visit, high severity), as mandated by the CMS Price Transparency Rule.
What CPT 99285 covers: the provider's professional fee for er visit (high severity). It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.
How to read this data
Negotiated Rate
The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.
P5, Median, P95
P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.
What this does not tell you
These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.
Top-Rated Hospitals in Massachusetts
These hospitals in Massachusetts are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
GREAT BARRINGTON, MA
BOSTON, MA
OAK BLUFFS, MA
BOSTON, MA
BOSTON, MA
Hospital ratings are based on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey data published by CMS.
Why ER Visit (High) Visit Costs Vary Across Massachusetts
Massachusetts emergency care costs run approximately 20% above national averages, reflecting the state's concentration of prestigious academic medical centers and higher overall healthcare spending. The state's compact geography means most residents can access multiple emergency facilities, creating some competitive pressure on pricing despite the premium market positioning.
Urban vs. Rural Provider Availability
Massachusetts's emergency care is heavily concentrated in the Boston metropolitan area, with world-class trauma centers like Mass General and Brigham and Women's serving as regional referral hubs. Rural areas in Western Massachusetts and Cape Cod rely on smaller community hospitals that may transfer the most complex cases to Boston, potentially affecting both access and total cost of care.
Facility Type and Overhead Costs
Massachusetts is home to numerous teaching hospitals affiliated with Harvard Medical School, Tufts University, and Boston University, which typically charge premium rates due to their academic missions and research overhead. Independent community hospitals like those in the Steward Health Care system may offer more competitive emergency pricing while still providing high-quality care.
Insurance Market Competition in Massachusetts
The state's insurance market is dominated by just three major players - BCBS Massachusetts, Tufts Health Plan, and Harvard Pilgrim - creating limited competition that can result in higher negotiated rates. This consolidated market means emergency facilities have less pressure to compete aggressively on pricing, contributing to the state's above-average emergency care costs.
Physician Supply and Demand in Massachusetts
With nearly 2,000 emergency medicine providers active across Massachusetts, the state maintains strong physician density relative to its population of 7 million residents. This robust supply helps maintain access to emergency care but doesn't necessarily drive down costs due to the state's affluent patient population and premium market positioning.
Jayant Panwar
CEO, Momentary Labs · San Francisco, CA
Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.
The cost figures on this page reflect his ongoing work to make this data accessible to patients.
Frequently Asked Questions — ER Visit (High) Costs in Massachusetts
What is the average cost of a ER Visit (High) visit in Massachusetts without insurance?
Does Massachusetts Medicaid cover ER Visit (High) visits?
How do I find an affordable ER Visit (High) near me in Massachusetts?
What is the difference in cost between an initial consultation and a follow-up visit?
Can I use an HSA or FSA to pay for a ER Visit (High) visit in Massachusetts?
How does telemedicine affect the cost of seeing a ER Visit (High) in Massachusetts?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 99285)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $73 – $940 | $430 |
| 2 | New Hampshire Range: $150 – $446 | $294 |
| 3 | Illinois Range: $80 – $569 | $285 |
| 4 | Iowa Range: $85 – $538 | $275 |
| 5 | Louisiana Range: $98 – $536 | $261 |
| 6 | New York Range: $80 – $543 | $260 |
| 7 | Maine Range: $170 – $337 | $251 |
| 8 | Nebraska Range: $123 – $422 | $236 |
| 9 | Washington Range: $80 – $379 | $224 |
| 10 | Colorado Range: $80 – $390 | $219 |
| 11 | New Mexico Range: $88 – $389 | $218 |
| 12 | Wyoming Range: $88 – $385 | $217 |
| 13 | Vermont Range: $98 – $356 | $216 |
| 14 | Rhode Island Range: $80 – $429 | $202 |
| 15 | Massachusetts Range: $80 – $428 | $202 |
| 16 | Georgia Range: $85 – $333 | $198 |
| 17 | North Carolina Range: $80 – $330 | $188 |
| 18 | District of Columbia Range: $85 – $305 | $185 |
| 19 | Maryland Range: $88 – $298 | $183 |
| 20 | Michigan Range: $80 – $318 | $183 |
| 21 | Utah Range: $80 – $317 | $182 |
| 22 | New Jersey Range: $60 – $348 | $182 |
| 23 | Ohio Range: $85 – $287 | $181 |
| 24 | Mississippi Range: $126 – $250 | $181 |
| 25 | California Range: $80 – $374 | $181 |
| 26 | Hawaii Range: $80 – $313 | $179 |
| 27 | Arkansas Range: $85 – $282 | $178 |
| 28 | Virginia Range: $88 – $293 | $177 |
| 29 | Tennessee Range: $85 – $259 | $170 |
| 30 | South Carolina Range: $80 – $287 | $170 |
| 31 | Missouri Range: $88 – $239 | $168 |
| 32 | Minnesota Range: $91 – $312 | $167 |
| 33 | Oklahoma Range: $85 – $246 | $166 |
| 34 | Kansas Range: $88 – $243 | $166 |
| 35 | Alabama Range: $80 – $257 | $160 |
| 36 | Pennsylvania Range: $55 – $334 | $159 |
| 37 | Arizona Range: $80 – $250 | $157 |
| 38 | Indiana Range: $85 – $298 | $157 |
| 39 | West Virginia Range: $88 – $281 | $155 |
| 40 | Delaware Range: $85 – $203 | $155 |
| 41 | Kentucky Range: $80 – $296 | $155 |
| 42 | Nevada Range: $85 – $267 | $154 |
| 43 | Alaska Range: $80 – $292 | $151 |
| 44 | Connecticut Range: $55 – $320 | $148 |
| 45 | Idaho Range: $80 – $275 | $148 |
| 46 | Oregon Range: $80 – $250 | $142 |
| 47 | Texas Range: $80 – $257 | $142 |
| 48 | Montana Range: $80 – $213 | $124 |
| 49 | North Dakota Range: $91 – $177 | $122 |
| 50 | South Dakota Range: $98 – $161 | $119 |
| 51 | Florida Range: $35 – $246 | $114 |