Cost of a ER Visit (Low) Visit
in Massachusetts
Reviewed by Momentary Medical Group West PC
Massachusetts leads the nation with 97% health insurance coverage, yet emergency department costs remain a significant concern for Bay State residents seeking low-severity care. ER Visit (Low) patients typically pay between $40 and $206, with a median out-of-pocket cost of $40 based on negotiated insurance rates. With 1,959 active ER Visit (Low) providers across Massachusetts, patients can browse all available options to find the most cost-effective care for their non-urgent medical needs.
Average
$95
Median
$40
Lowest
$40
Highest
$206
Providers
1,959
2% above national average
Compare Similar Procedures
How does er visit (low severity) compare to related procedures in Massachusetts?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| ER Visit (Moderate Severity) Emergency department visit, moderate severity | 99284 | $62 | $80 | $368 | 2,064 |
| ER Visit (High Severity) Emergency department visit, high severity | 99285 | $80 | $98 | $428 | 1,941 |
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 99283 — Emergency department visit, low to moderate 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 99283 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 99283 (Emergency department visit, low to moderate severity), as mandated by the CMS Price Transparency Rule.
What CPT 99283 covers: the provider's professional fee for er visit (low 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 (Low) Visit Costs Vary Across Massachusetts
Massachusetts healthcare costs run approximately 20% above the national average, driven by the concentration of world-renowned academic medical centers and high cost of living throughout the Commonwealth. The state's highly consolidated hospital market, dominated by systems like Mass General Brigham and UMass Memorial, creates pricing power that affects emergency department rates statewide.
Urban vs. Rural Provider Availability
Greater Boston's dense concentration of emergency facilities contrasts sharply with rural Western Massachusetts, where patients may have limited options and longer transport times to appropriate care. This geographic disparity means rural residents often pay premium rates at the few available facilities, while urban patients can comparison shop among multiple options.
Facility Type and Overhead Costs
Hospital-based emergency departments in Massachusetts carry significantly higher overhead costs than urgent care centers, with prestigious academic medical centers like Massachusetts General commanding the highest rates. Independent community hospitals often offer more affordable emergency care while still maintaining quality standards, particularly in suburban markets like MetroWest.
Insurance Market Competition in Massachusetts
The Big Three insurers - Blue Cross Blue Shield MA, Tufts Health Plan, and Harvard Pilgrim - negotiate different rates with emergency providers, creating cost variations even for the same service. This competitive dynamic, while better than monopolistic markets, still results in limited negotiating power against large hospital systems with significant market presence.
Physician Supply and Demand in Massachusetts
With 1,959 active ER Visit (Low) providers serving approximately 7 million residents, Massachusetts maintains adequate emergency medicine capacity in urban areas but faces challenges in rural regions. This supply-demand balance keeps urban emergency department wait times reasonable while potentially driving up costs in underserved areas where demand exceeds local capacity.
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 (Low) Costs in Massachusetts
What is the average cost of a ER Visit (Low) visit in Massachusetts without insurance?
Does Massachusetts Medicaid cover ER Visit (Low) visits?
How do I find an affordable ER Visit (Low) 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 (Low) visit in Massachusetts?
How does telemedicine affect the cost of seeing a ER Visit (Low) in Massachusetts?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 99283)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Pennsylvania Range: $47 – $693 | $271 |
| 2 | Wisconsin Range: $56 – $355 | $180 |
| 3 | Illinois Range: $57 – $252 | $133 |
| 4 | Maine Range: $86 – $184 | $131 |
| 5 | New Hampshire Range: $59 – $204 | $130 |
| 6 | Michigan Range: $54 – $252 | $126 |
| 7 | Iowa Range: $44 – $218 | $119 |
| 8 | Rhode Island Range: $40 – $204 | $111 |
| 9 | California Range: $80 – $153 | $107 |
| 10 | Vermont Range: $53 – $171 | $107 |
| 11 | Indiana Range: $57 – $171 | $105 |
| 12 | New York Range: $47 – $202 | $105 |
| 13 | Washington Range: $57 – $167 | $101 |
| 14 | Colorado Range: $54 – $159 | $99 |
| 15 | Wyoming Range: $54 – $155 | $97 |
| 16 | Idaho Range: $60 – $142 | $96 |
| 17 | Nebraska Range: $44 – $171 | $95 |
| 18 | Massachusetts Range: $40 – $206 | $95 |
| 19 | Utah Range: $53 – $139 | $93 |
| 20 | District of Columbia Range: $49 – $142 | $92 |
| 21 | Maryland Range: $43 – $162 | $91 |
| 22 | Connecticut Range: $53 – $153 | $90 |
| 23 | Georgia Range: $53 – $143 | $90 |
| 24 | Alaska Range: $69 – $118 | $89 |
| 25 | New Mexico Range: $54 – $139 | $88 |
| 26 | Kentucky Range: $40 – $139 | $88 |
| 27 | Hawaii Range: $54 – $139 | $87 |
| 28 | Texas Range: $54 – $118 | $86 |
| 29 | North Carolina Range: $51 – $136 | $85 |
| 30 | New Jersey Range: $44 – $142 | $84 |
| 31 | South Carolina Range: $51 – $128 | $83 |
| 32 | Arkansas Range: $51 – $115 | $81 |
| 33 | Nevada Range: $60 – $108 | $81 |
| 34 | Alabama Range: $49 – $131 | $80 |
| 35 | Virginia Range: $47 – $119 | $79 |
| 36 | Arizona Range: $53 – $107 | $77 |
| 37 | Ohio Range: $43 – $117 | $77 |
| 38 | Minnesota Range: $40 – $145 | $75 |
| 39 | Tennessee Range: $51 – $105 | $75 |
| 40 | Oklahoma Range: $51 – $104 | $75 |
| 41 | Delaware Range: $60 – $90 | $74 |
| 42 | Missouri Range: $52 – $99 | $74 |
| 43 | Mississippi Range: $51 – $104 | $73 |
| 44 | Montana Range: $40 – $91 | $70 |
| 45 | Kansas Range: $51 – $91 | $70 |
| 46 | Florida Range: $35 – $110 | $67 |
| 47 | West Virginia Range: $40 – $115 | $65 |
| 48 | Louisiana Range: $40 – $87 | $63 |
| 49 | Oregon Range: $40 – $108 | $63 |
| 50 | North Dakota Range: $40 – $91 | $57 |
| 51 | South Dakota Range: $40 – $88 | $56 |