CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Melrosewakefield Healthcare

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$8,143

about 1.4× the $5,676 Medicare rate · typically $6,990–$11,465

modeled estimate · not a bill or quote

What this hospital charges insurers

$6,985

Below the fair price — a good deal

about $1,158 under the fair price · 1.2× Medicare

Medicare pays $5,676 Fair price $8,143 This hospital $6,985 Cash price $8,718 Hospital's list price $12,455

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

Highest price of the 9 MA hospitals we have prices for — worth calling around.

Cheapest $4,909 Priciest $6,985

Black dot = this hospital, among the 9 MA hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $8,143 (about 1.4× the $5,676 Medicare rate). Melrosewakefield Healthcare charges insurers about $6,985, or about $8,718 in cash — below the fair price — a good deal. Located in Melrose, MA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$6,985 - $7,063	123%
Blue Cross Blue Shieldmajor	$7,063 - $8,307	124%
Aetnamajor	$3,984	70%
Cignamajor	$6,985	123%
Humanamajor	$6,985	123%
Harvard Pilgrim	$6,985	123%
Tufts Health Plan	$11,772	207%
+ 10 smaller / regional plans	$3,105 - $12,823

Government programs also on file: Medicare, Medicaid, Military & VA.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 8,718), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Melrosewakefield Healthcare is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Melrosewakefield Healthcare

Compare: Digestive disorders treatment (inpatient stay) at other MA hospitals

Fairview Hospital · Great Barrington $4,909
North Adams Regional Hospital Corporation · North Adams $5,164
Beth Israel Deaconess Hospital - Milton · Milton $5,558
Newton-Wellesley Hospital · Newton $6,619
Emerson Hospital - · W Concord $6,647
Winchester Hospital · Winchester $6,676
Heywood Hospital - · Gardner $6,781
Anna Jaques Hospital · Newburyport $6,916

Insurance negotiated median for the same procedure, sorted lowest first.