Cost of a ER Visit (Moderate) Visit
in Massachusetts
Reviewed by Momentary Medical Group West PC
Massachusetts leads the nation with the highest rate of insured residents at 97%, yet ER Visit (Moderate) costs still create financial barriers for many patients. Across the state's 2,064 active emergency departments, patients typically pay between $62 and $368 for moderate-severity emergency care, with a median out-of-pocket cost of $80. You can browse all ER providers in Massachusetts to compare costs and check your insurance coverage before your visit.
Average
$170
Median
$80
Lowest
$62
Highest
$368
Providers
2,064
20% above national average
Compare Similar Procedures
How does er visit (moderate 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 (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 99284 — Emergency department visit, 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 99284 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 99284 (Emergency department visit, moderate severity), as mandated by the CMS Price Transparency Rule.
What CPT 99284 covers: the provider's professional fee for er visit (moderate 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 (Moderate) Visit Costs Vary Across Massachusetts
Massachusetts healthcare costs run approximately 20% above the national average, driven by the state's concentration of world-renowned academic medical centers and a highly educated physician workforce. The Commonwealth's compact geography creates unique cost dynamics where Boston's premium pricing influences rates statewide, even in smaller communities.
Urban vs. Rural Provider Availability
Western Massachusetts and Cape Cod face provider shortages compared to the Boston metro area, where major medical centers like Mass General Brigham and Beth Israel Lahey Health concentrate resources. Rural emergency departments often transfer moderate-severity cases to Boston hospitals, adding transport costs and complexity to billing.
Facility Type and Overhead Costs
Hospital-based emergency departments in Massachusetts carry higher overhead costs than urgent care centers, reflected in facility fees that can add hundreds of dollars to bills. The state's dominant health systems—Mass General Brigham, Beth Israel Lahey Health, and Tufts Medicine—operate most major emergency departments with premium pricing structures.
Insurance Market Competition in Massachusetts
Despite having three major insurers (BCBS MA, Tufts, and Harvard Pilgrim), Massachusetts maintains relatively concentrated market power among payers, leading to standardized but higher negotiated rates. The state's strict insurance regulations create predictable coverage but limit price competition among emergency care providers.
Physician Supply and Demand in Massachusetts
With 2,064 active emergency medicine providers, Massachusetts maintains adequate physician supply relative to its population, though geographic concentration in Boston creates access disparities. This supply-demand balance keeps wait times reasonable but doesn't significantly reduce pricing due to the state's premium healthcare 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 (Moderate) Costs in Massachusetts
What is the average cost of a ER Visit (Moderate) visit in Massachusetts without insurance?
Does Massachusetts Medicaid cover ER Visit (Moderate) visits?
How do I find an affordable ER Visit (Moderate) 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 (Moderate) visit in Massachusetts?
How does telemedicine affect the cost of seeing a ER Visit (Moderate) in Massachusetts?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 99284)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $73 – $647 | $311 |
| 2 | Illinois Range: $80 – $431 | $223 |
| 3 | Iowa Range: $80 – $371 | $205 |
| 4 | New Hampshire Range: $102 – $307 | $202 |
| 5 | Pennsylvania Range: $55 – $431 | $191 |
| 6 | New York Range: $67 – $374 | $183 |
| 7 | Rhode Island Range: $62 – $374 | $177 |
| 8 | Maine Range: $116 – $233 | $172 |
| 9 | Massachusetts Range: $62 – $368 | $170 |
| 10 | Nebraska Range: $83 – $291 | $165 |
| 11 | Washington Range: $80 – $259 | $161 |
| 12 | Michigan Range: $80 – $291 | $158 |
| 13 | New Mexico Range: $85 – $266 | $158 |
| 14 | Wyoming Range: $85 – $262 | $157 |
| 15 | Colorado Range: $80 – $267 | $157 |
| 16 | Vermont Range: $80 – $257 | $156 |
| 17 | Georgia Range: $84 – $246 | $151 |
| 18 | California Range: $80 – $258 | $142 |
| 19 | Indiana Range: $80 – $258 | $142 |
| 20 | Kentucky Range: $70 – $246 | $140 |
| 21 | North Carolina Range: $80 – $231 | $139 |
| 22 | District of Columbia Range: $80 – $217 | $138 |
| 23 | West Virginia Range: $62 – $174 | $137 |
| 24 | Utah Range: $80 – $228 | $135 |
| 25 | Maryland Range: $80 – $206 | $132 |
| 26 | New Jersey Range: $60 – $237 | $131 |
| 27 | Hawaii Range: $80 – $217 | $130 |
| 28 | Arkansas Range: $80 – $194 | $130 |
| 29 | Virginia Range: $81 – $202 | $129 |
| 30 | Tennessee Range: $85 – $187 | $128 |
| 31 | South Carolina Range: $80 – $206 | $128 |
| 32 | Ohio Range: $75 – $197 | $127 |
| 33 | Missouri Range: $85 – $167 | $124 |
| 34 | Alabama Range: $80 – $195 | $124 |
| 35 | Oklahoma Range: $85 – $169 | $123 |
| 36 | Kansas Range: $86 – $167 | $123 |
| 37 | Texas Range: $80 – $196 | $122 |
| 38 | Arizona Range: $80 – $187 | $122 |
| 39 | Mississippi Range: $86 – $165 | $121 |
| 40 | Idaho Range: $80 – $194 | $121 |
| 41 | Delaware Range: $80 – $157 | $120 |
| 42 | Minnesota Range: $62 – $233 | $119 |
| 43 | Nevada Range: $84 – $184 | $119 |
| 44 | Connecticut Range: $55 – $211 | $118 |
| 45 | Alaska Range: $80 – $194 | $118 |
| 46 | Louisiana Range: $62 – $150 | $104 |
| 47 | Oregon Range: $62 – $183 | $102 |
| 48 | Montana Range: $62 – $145 | $96 |
| 49 | Florida Range: $35 – $190 | $95 |
| 50 | North Dakota Range: $62 – $121 | $82 |
| 51 | South Dakota Range: $62 – $121 | $82 |