How many shoppable procedure prices are published for Cambridge Health Alliance?

Cambridge Health Alliance in Cambridge, MA currently has 116 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Cambridge Health Alliance's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Cambridge Health Alliance's median negotiated commercial rate is 1.8× the regionally adjusted fair BaseRate benchmark.

What is Cambridge Health Alliance's CMS Care Compare overall star rating?

CMS Care Compare assigns Cambridge Health Alliance an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Government - Local 225 Beds · urban Updated: 3/20/2026

Cambridge Health Alliance

1493 Cambridge Street, Cambridge, MA 02139 · 116 Priced Procedures · 64% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

High Markup · Shop Alternatives

1.76×vs. Fair Market Price

Typical commercial prices here are +76% above the fair benchmark (1.76×) even after accounting for local nurse/doctor wages and patient complexity.

58/100 · Caution

58/100Self-Pay Cash Beats Insurance 8% of the Time

File Completeness60

Price Logic66

Peer Alignment69

Clean Billing83

Real Cash Discount6

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 1.76× fair market pricing.

Behavioral Pricing FingerprintHigh Infusion / OR Multiples

Specialty Drug & Surgical Margin Engine

Cambridge Health Alliance concentrates commercial margin in outpatient surgical suites (4.4× Medicare) and specialty drug infusions (1.8× Medicare) relative to routine diagnostics (1.9×). Comparing freestanding ambulatory surgery centers or specialty pharmacy options before treatment yields substantial savings.

#44 of 53 in MA · 81st State Percentile#2,928 of 3,385 in U.S. · 86th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.65× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 8% of shoppable procedures (25/100 Cash Honesty)
CMS clinical safety score (64/100 safety score) with 64% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 4.4× markup over Medicare rates
Commercial insurance median sits at 1.90× Fair BaseRate (2.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
Specialty infusion drugs (J-codes) average 1.8× Medicare — verify per-unit billing on itemized statements
Unnegotiated chargemaster list prices average 5.8× Medicare (30¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.1× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.90× Divergence

1.9× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+8% Upper Tail

Q25 1.65× · Q50 1.90× · Q75 2.05×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

2.1× MedicareGood

Outpatient Surgery & ORBack-Door Captive

4.4× MedicareWatchout

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

3.1× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

1.8× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.8× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

8% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 64/100Elevated

Procedure Prices at Cambridge Health Alliance

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 116 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$40,458	$29,031	$19,087	unverified
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$31,696	$17,502	$8,223	unverified
Total hip replacement CPT Code: `27130`	$16,747	$16,747	$13,413	unverified
Total knee replacement CPT Code: `27447`	$15,814	$15,814	$13,523	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$15,721	$15,721	$19,432	unverified
Gallbladder removal (laparoscopic) CPT Code: `47562`	$7,691	$5,256	$6,109	0.9×
Inguinal hernia repair CPT Code: `49505`	$6,701	$3,370	$3,629	0.9×
Breast lump removal CPT Code: `19120`	$3,839	$3,220	$3,875	0.8×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$5,707	$3,000	$3,372	0.9×
Bunion correction surgery CPT Code: `28296`	$6,978	$3,000	$3,446	0.9×
Colonoscopy (diagnostic) CPT Code: `45378`	$2,578	$2,578	$981	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	$3,500	$2,318	$1,021	unverified
Blood transfusion CPT Code: `36430`	$1,942	$1,942	$498	unverified
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,725	$1,317	$583	unverified
Colonoscopy with biopsy CPT Code: `45380`	$3,230	$1,120	$1,256	0.9×
MRI, brain (with and without contrast) CPT Code: `70553`	$4,370	$986	$511	1.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,825	$846	$448	1.9×
Upper endoscopy with biopsy CPT Code: `43239`	$3,316	$871	$987	0.9×
MRI, lower back (no contrast) CPT Code: `72148`	$2,467	$629	$338	1.9×
MRI, brain (no contrast) CPT Code: `70551`	$2,467	$629	$343	1.8×
MRI, knee or other leg joint CPT Code: `73721`	$1,603	$629	$369	1.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$661	$575	$272	2.1×
Rabies immune globulin HCPCS Code: `90375`	$2,574	$577	$322	1.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$3,085	$529	$303	1.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,898	$551	$258	unverified
CT scan, head (with contrast) CPT Code: `70460`	$902	$496	$242	2.0×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$635	$303	$148	2.0×
CT scan, head (no contrast) CPT Code: `70450`	$1,392	$321	$160	2.0×
CT scan, pelvis CPT Code: `72192`	$1,973	$321	$163	2.0×
CT scan, sinuses CPT Code: `70486`	$1,809	$321	$166	1.9×
CT scan, chest (no contrast) CPT Code: `71250`	$1,661	$321	$167	1.9×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$937	$321	$168	1.9×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,973	$321	$169	1.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$341	$341	$181	unverified
Ultrasound, thyroid and neck CPT Code: `76536`	$802	$281	$132	2.1×
Ultrasound, abdomen (complete) CPT Code: `76700`	$550	$282	$134	2.1×
Ultrasound, pelvis CPT Code: `76856`	$798	$300	$130	unverified
Screening mammogram (both breasts) CPT Code: `77067`	$635	$286	$123	unverified
Ultrasound, abdomen (limited) CPT Code: `76705`	$550	$250	$126	2.0×
Neurobehavioral status check CPT Code: `96116`	$257	$257	$231	unverified
Psychiatric evaluation (first visit) CPT Code: `90791`	$225	$225	$185	1.2×
X-ray, lower back CPT Code: `72110`	$370	$250	$112	unverified
X-ray, pelvis CPT Code: `72170`	$840	$250	$110	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$350	$188	$86	2.2×
X-ray, chest (single view) CPT Code: `71045`	$625	$186	$92	2.0×
X-ray, shoulder CPT Code: `73030`	$625	$186	$92	2.0×
X-ray, foot CPT Code: `73630`	$400	$186	$92	2.0×
X-ray, chest (two views) CPT Code: `71046`	$625	$186	$93	2.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$247	$186	$93	2.0×
X-ray, hand CPT Code: `73130`	$312	$186	$93	2.0×
X-ray, hip CPT Code: `73502`	$625	$186	$93	2.0×
X-ray, ankle CPT Code: `73610`	$321	$186	$93	unverified
Family therapy session CPT Code: `90847`	$181	$181	$173	unverified
Hepatitis B immune globulin HCPCS Code: `90371`	$163	$142	$151	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$380	$110	$38	2.9×
Psychotherapy session (45 minutes) CPT Code: `90834`	$133	$133	$166	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$179	$141	$64	unverified
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$253	$114	$38	3.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$380	$126	$40	unverified
Physical therapy (therapeutic exercise) CPT Code: `97110`	$253	$98	$35	2.8×
Physical therapy (manual therapy) CPT Code: `97140`	$380	$90	$34	2.6×
Physical therapy (functional capacity test) CPT Code: `97750`	$95	$95	$38	2.5×
Orthotic fitting and training CPT Code: `97760`	$100	$100	$51	unverified
Typhoid vaccine HCPCS Code: `90675`	$285	$285	$347	0.8×
Drug screening test HCPCS Code: `G0480`	$120	$120	$116	1.0×
Pneumococcal vaccine HCPCS Code: `90732`	$240	$133	$140	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$150	$150	$203	0.7×
Speech therapy (group session) CPT Code: `92508`	$173	$62	$27	2.3×
Blood antibody screen CPT Code: `86850`	$200	$76	$46	1.7×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$100	$100	$111	0.9×
Physical therapy (gait training) CPT Code: `97116`	$63	$63	$33	1.9×
Blood test, vitamin D CPT Code: `82306`	$90	$58	$31	1.9×
Colorectal cancer screening HCPCS Code: `G0010`	$80	$80	$49	1.6×
Diagnostic procedure preparation HCPCS Code: `G0279`	$75	$55	$35	1.6×
Pneumonia vaccine injection HCPCS Code: `G0009`	$68	$68	$49	1.4×
Care planning with family CPT Code: `90887`	$45	$45	$107	0.4×
Group therapy session CPT Code: `90853`	$58	$58	$100	unverified
Breathing treatment (nebulizer) CPT Code: `94640`	$70	$70	$201	unverified
Psychological testing evaluation CPT Code: `96136`	$183	$44	$128	0.3×
Prosthetic fitting and training CPT Code: `97761`	$64	$64	$45	unverified
Flu vaccine injection HCPCS Code: `G0008`	$80	$80	$48	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$20	$6	$3	2.0×
Blood test, calcium CPT Code: `82310`	$23	$10	$5	2.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$23	$10	$5	2.0×
Blood test, lipase CPT Code: `83690`	$50	$14	$7	2.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$36	$12	$6	2.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$72	$27	$14	1.9×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$320	$21	$11	1.9×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$41	$19	$10	1.9×
Blood test, basic metabolic panel CPT Code: `80048`	$183	$17	$9	1.9×
Culture, bacterial CPT Code: `87070`	$64	$17	$9	1.9×
Blood test, vitamin B12 CPT Code: `82607`	$73	$30	$16	1.9×
Blood test, complete blood count (CBC) CPT Code: `85025`	$46	$15	$8	1.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$86	$26	$14	1.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$90	$33	$18	1.8×
Culture, blood CPT Code: `87040`	$79	$20	$11	1.8×
Psychological testing by technician CPT Code: `96138`	$313	$40	$395	0.1×
Blood test, amylase CPT Code: `82150`	$97	$13	$7	1.9×
Blood test, magnesium CPT Code: `83735`	$38	$13	$7	1.9×
Blood test, potassium CPT Code: `84132`	$23	$9	$5	1.8×
Blood test, sodium CPT Code: `84295`	$18	$9	$5	1.8×
Blood test, liver function panel CPT Code: `80076`	$160	$16	$9	1.8×
Blood test, glucose (blood sugar) CPT Code: `82947`	$22	$7	$4	1.8×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$21	$7	$4	1.8×
Blood test, hemoglobin CPT Code: `85018`	$14	$5	$3	1.7×
Hepatitis C antibody test CPT Code: `86803`	$114	$24	$15	1.6×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$55	$32	$20	1.6×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$24	$7	$5	1.4×
Blood test, PSA (prostate screen) CPT Code: `84153`	$55	$25	$19	1.3×
Behavioral health outpatient services HCPCS Code: `H2015`	$20	$20	$16	1.3×
Flu vaccine (high dose) HCPCS Code: `90656`	$25	$21	$25	0.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$51	$40	$56	0.7×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$13	$13	$39	0.3×
New patient office visit (30-44 min) CPT Code: `99203`	$135	$31	$110	0.3×
Office visit, established patient (20-29 min) CPT Code: `99213`	$165	$30	$87	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$230	$30	$123	unverified

Showing top 25 high-impact procedures of 116 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Cambridge Health Alliance (Zero PHI Required)

CMS CCN: 220011

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash $40,458

Insurer Median $29,031

1. Amount on Your Bill or Quote ($) Pre-filled with Cambridge Health Alliance’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $40,458

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Cambridge Health Alliance's published 45 CFR § 180 self-pay cash rate is $40,458 (vs. $29,031 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$21,371 Above Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your bill ($40,458) is $21,371 above the denoised Fair BaseRate ($19,087) and 2.9× the $14,117 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Public IRS & CMS ownership records classify Cambridge Health Alliance as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite64/100

Would Recommend64%

Rated 9 or 10 (HCAHPS)64%

Median ER Wait164 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.8%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (483 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Cambridge Health Alliance.

Price Index: 1.32× regional baseline

Quality: 58/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Humana

+71.7%

Median Household Income$126,779U.S. Census ACS

Local Uninsured Share2.4%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 58/100 · Caution CMS CCN 220011

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (PriceTransparency20262320.csv) Verify on CMS Medicare.gov (CCN 220011) ↗ CMS HCRIS Cost Reports ↗

Published MRF FilePriceTransparency20262320.csv

Publication / Vintage3/20/2026 · 265.41 MB

Validated Rate Rows6,002 (CMS v3.0.0)

File Integrity DigestVerified · CCN 220011

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy