CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: The Shriners' Hospital for Children - Boston

Billing Code: 99203 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$120
about 1.0× the $118 Medicare rate · typically $68–$274
modeled estimate · not a bill or quote
What this hospital charges insurers
$76
Below the fair price — a good deal
about $44 under the fair price · 0.6× Medicare
Medicare pays $118 Fair price $120 This hospital $76 Cash price $447 Hospital's list price $447

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

A typical price — 3 charge more and 5 charge less, among the 9 MA hospitals compared.

Cheapest $27 Priciest $100

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a New patient office visit (30-44 min) is about $120 (about 1.0× the $118 Medicare rate). The Shriners' Hospital for Children - Boston charges insurers about $76, or about $447 in cash — below the fair price — a good deal. Located in Boston, MA.

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna UnitedHealthcareCignaHumanaKaiser 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
Blue Cross Blue Shieldmajor $553 470%
Aetnamajor $76 65%
Ambetter (Centene) $47 40%
Tufts Health Plan $817 695%
+ 3 smaller / regional plans $47 - $106

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

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

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Facility Profile & Credentials

  • Address: 51 Blossom Street, Boston, MA 02114
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Childrens