How many shoppable procedure prices are published for Lahey Hospital & Medical Center, Burlington?

Lahey Hospital & Medical Center, Burlington in Burlington, MA currently has 127 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Lahey Hospital & Medical Center, Burlington's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Lahey Hospital & Medical Center, Burlington's median negotiated commercial rate is 1.8× the regionally adjusted fair BaseRate benchmark.

What is Lahey Hospital & Medical Center, Burlington's CMS Care Compare overall star rating?

CMS Care Compare assigns Lahey Hospital & Medical Center, Burlington an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 344 Beds · urban Updated: 2026-04-01

Lahey Hospital & Medical Center, Burlington

41 & 45 Mall Road, Burlington, MA 01803 · 127 Priced Procedures · 73% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

High Markup · Shop Alternatives

1.79×vs. Fair Market Price

Typical commercial prices here are +79% above the fair benchmark (1.79×) even after accounting for local nurse/doctor wages and patient complexity.

69/100 · Caution

69/100Self-Pay Cash Beats Insurance 5% of the Time

File Completeness100

Price Logic78

Peer Alignment74

Clean Billing74

Real Cash Discount6

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 1.79× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Lahey Hospital & Medical Center, Burlington prices shoppable and inpatient services (2.3× to 2.2× Medicare, divergence 0.96×) in alignment with regional hospital peers (1.79× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#45 of 53 in MA · 83rd State Percentile#2,955 of 3,385 in U.S. · 87th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.52× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 5% of shoppable procedures (25/100 Cash Honesty)
4-Star CMS clinical rating with 73% patient recommendation (66/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (34.8% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.79× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Commercial insurance median sits at 1.98× Fair BaseRate (2.3× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.37×) jump +20% above the median procedure ratio (Q50 1.98×)
Unnegotiated chargemaster list prices average 7.5× Medicare (18¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.3× Medicare

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

Back-Door Captive & ER0.96× Divergence

2.2× Medicare

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

Quantile Tail Spread+20% Upper Tail

Q25 1.52× · Q50 1.98× · Q75 2.37×

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

2.3× MedicareFair

Outpatient Surgery & ORBack-Door Captive

0.7× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.5× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

1.0× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.9× MedicareFair

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

0.8× MedicareGood

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

5% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 66/100Fair

Procedure Prices at Lahey Hospital & Medical Center, Burlington

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 127 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$50,547	$30,775	unverified
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$30,395	$19,087	1.6×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$30,182	$19,432	1.6×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$29,477	$17,936	1.6×
Total knee replacement CPT Code: `27447`	—	$20,584	$13,523	1.5×
Total hip replacement CPT Code: `27130`	—	$19,608	$13,413	1.5×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$12,199	$8,223	1.5×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$7,054	$6,109	1.2×
Vaginal delivery (full package) CPT Code: `59400`	$7,678	$6,903	$2,680	2.6×
Inguinal hernia repair CPT Code: `49505`	—	$6,508	$3,629	1.8×
Breast lump removal CPT Code: `19120`	$6,709	$6,218	$3,875	1.6×
Bunion correction surgery CPT Code: `28296`	—	$5,793	$3,446	1.7×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$6,709	$4,311	$3,372	1.3×
Cataract surgery with lens implant CPT Code: `66984`	—	$4,233	$2,540	1.7×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,618	$2,151	$1,021	2.1×
Trauma team activation HCPCS Code: `G0390`	$4,774	$2,088	$1,453	1.4×
Colonoscopy with biopsy CPT Code: `45380`	$2,868	$1,870	$1,256	1.5×
Upper endoscopy with biopsy CPT Code: `43239`	$2,825	$1,629	$987	1.7×
Colonoscopy (diagnostic) CPT Code: `45378`	$2,868	$1,610	$981	1.6×
Injection procedure for pain management HCPCS Code: `G0260`	—	$1,322	$855	1.5×
MRI, brain (with and without contrast) CPT Code: `70553`	$4,115	$1,261	$511	unverified
Blood transfusion CPT Code: `36430`	$2,172	$1,133	$498	2.3×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,250	$1,140	$583	2.0×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,991	$1,142	$448	unverified
MRI, brain (no contrast) CPT Code: `70551`	$2,945	$786	$343	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$2,945	$786	$338	unverified
MRI, knee or other leg joint CPT Code: `73721`	$2,945	$786	$369	unverified
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,240	$682	$303	2.3×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,492	$687	$258	unverified
CT scan, head (with contrast) CPT Code: `70460`	$1,205	$653	$242	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$933	$596	$272	unverified
Neurobehavioral status check CPT Code: `96116`	$3,944	$581	$231	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$426	$426	$86	unverified
Breathing treatment (nebulizer) CPT Code: `94640`	$439	$438	$201	unverified
CT scan, head (no contrast) CPT Code: `70450`	$1,058	$383	$160	2.4×
CT scan, pelvis CPT Code: `72192`	$1,331	$383	$163	2.3×
CT scan, sinuses CPT Code: `70486`	$1,181	$383	$166	2.3×
CT scan, chest (no contrast) CPT Code: `71250`	$1,443	$383	$167	2.3×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,366	$383	$168	2.3×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,476	$383	$169	2.3×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$749	$371	$148	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,214	$282	$134	2.1×
Rabies immune globulin HCPCS Code: `90375`	$540	$300	$322	0.9×
X-ray, lower back CPT Code: `72110`	$560	$282	$112	unverified
X-ray, pelvis CPT Code: `72170`	$275	$275	$110	unverified
Ultrasound, thyroid and neck CPT Code: `76536`	$807	$282	$132	unverified
Ultrasound, abdomen (limited) CPT Code: `76705`	$751	$282	$126	unverified
Ultrasound, pelvis CPT Code: `76856`	$980	$282	$130	unverified
Screening mammogram (both breasts) CPT Code: `77067`	$728	$307	$123	unverified
Behavioral health day program HCPCS Code: `H2012`	—	$188	$100	1.9×
X-ray, chest (single view) CPT Code: `71045`	$206	$184	$92	unverified
X-ray, chest (two views) CPT Code: `71046`	$206	$184	$93	unverified
X-ray, foot CPT Code: `73630`	$333	$156	$92	1.7×
X-ray, neck (cervical spine) CPT Code: `72040`	$378	$156	$93	1.7×
X-ray, hand CPT Code: `73130`	$326	$156	$93	1.7×
X-ray, hip CPT Code: `73502`	$223	$156	$93	1.7×
X-ray, ankle CPT Code: `73610`	$343	$156	$93	1.7×
New patient office visit (30-44 min) CPT Code: `99203`	$236	$170	$110	1.5×
Office visit, established patient (30-39 min) CPT Code: `99214`	$236	$169	$123	1.4×
Mental health services (assessment) HCPCS Code: `H0031`	—	$188	$140	1.3×
Orthotic fitting and training CPT Code: `97760`	$225	$143	$51	2.8×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$436	$130	$64	2.0×
Care planning with family CPT Code: `90887`	—	$153	$107	1.4×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$148	$151	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	$501	$159	$185	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$366	$154	$181	0.9×
X-ray, shoulder CPT Code: `73030`	$330	$156	$92	unverified
Physical therapy (functional capacity test) CPT Code: `97750`	$225	$116	$38	3.1×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$196	$115	$38	3.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$207	$119	$40	3.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	$236	$115	$87	1.3×
Family therapy session CPT Code: `90847`	$428	$129	$173	0.7×
Prosthetic fitting and training CPT Code: `97761`	$225	$136	$45	unverified
Speech therapy (group session) CPT Code: `92508`	$336	$84	$27	3.1×
Physical therapy (gait training) CPT Code: `97116`	$176	$99	$33	3.0×
Occupational therapy (self-care training) CPT Code: `97535`	$207	$113	$38	3.0×
Physical therapy (manual therapy) CPT Code: `97140`	$176	$91	$34	2.7×
Psychotherapy session (45 minutes) CPT Code: `90834`	$366	$103	$166	0.6×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$204	$111	$25	unverified
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$81	$35	2.3×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$185	$101	$35	unverified
Drug screening test HCPCS Code: `G0480`	$1,055	$1,055	$116	9.1×
Typhoid vaccine HCPCS Code: `90675`	$611	$343	$347	1.0×
Blood test, vitamin D CPT Code: `82306`	$194	$194	$31	6.3×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$204	$204	$203	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$130	$130	$20	6.5×
Blood test, PSA (prostate screen) CPT Code: `84153`	$121	$121	$19	6.4×
Blood test, vitamin B12 CPT Code: `82607`	$101	$101	$16	6.3×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$117	$117	$111	1.1×
Pneumococcal vaccine HCPCS Code: `90732`	$123	$123	$140	0.9×
Blood test, calcium CPT Code: `82310`	$75	$75	$5	15.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$75	$75	$5	15.0×
Blood test, potassium CPT Code: `84132`	$75	$75	$5	15.0×
Blood test, sodium CPT Code: `84295`	$75	$75	$5	15.0×
Blood test, lipase CPT Code: `83690`	$87	$87	$7	12.4×
Blood test, amylase CPT Code: `82150`	$75	$75	$7	10.7×
Blood test, magnesium CPT Code: `83735`	$75	$75	$7	10.7×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$75	$75	$10	7.5×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$84	$49	1.7×
Colorectal cancer screening HCPCS Code: `G0010`	—	$84	$49	1.7×
Blood test, ferritin (iron stores) CPT Code: `82728`	$91	$91	$14	unverified
Flu vaccine injection HCPCS Code: `G0008`	$272	$84	$48	unverified
Blood test, complete blood count (CBC) CPT Code: `85025`	$58	$58	$8	7.3×
Blood test, liver function panel CPT Code: `80076`	$61	$61	$9	6.8×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$73	$73	$14	5.2×
Electrical stimulation therapy HCPCS Code: `G0283`	—	$45	$14	3.2×
Blood test, thyroid (TSH) CPT Code: `84443`	$113	$41	$18	2.3×
Blood antibody screen CPT Code: `86850`	$122	$58	$46	1.3×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$230	$60	$56	1.1×
Psychological testing evaluation CPT Code: `96136`	$1,564	$51	$128	0.4×
Psychological testing by technician CPT Code: `96138`	$316	$50	$395	0.1×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$58	$8	$3	2.7×
Blood test, glucose (blood sugar) CPT Code: `82947`	$75	$10	$4	2.5×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$75	$10	$4	2.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$58	$15	$6	2.5×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$127	$26	$11	2.4×
Blood test, basic metabolic panel CPT Code: `80048`	$61	$21	$9	2.3×
Culture, bacterial CPT Code: `87070`	$116	$21	$9	2.3×
Culture, blood CPT Code: `87040`	$116	$25	$11	2.3×
Hepatitis C antibody test CPT Code: `86803`	$72	$31	$15	2.1×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$38	$39	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	$65	$36	$37	1.0×
Blood test, hemoglobin CPT Code: `85018`	$58	$6	$3	2.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$58	$10	$5	2.0×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$25	$25	1.0×
Behavioral health living support HCPCS Code: `H2019`	—	$23	$34	0.7×
Group therapy session CPT Code: `90853`	$186	$31	$100	0.3×

Showing top 25 high-impact procedures of 127 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 34.8%

Audit a Bill or Quote at Lahey Hospital & Medical Center, Burlington (Zero PHI Required)

CMS CCN: 220171

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $50,547

1. Amount on Your Bill or Quote ($) Pre-filled with Lahey Hospital & Medical Center, Burlington’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 501(r) AGB Cap: $42,265 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $42,265

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (34.8% of gross = $42,265).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Lahey Hospital & Medical Center, Burlington's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$90,538 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($121,313) is $90,538 above the denoised Fair BaseRate ($30,775) and 5.2× the $23,504 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) 501(c)(3) Nonprofit Hospital

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

EIN: 042704686

Filing Period: 199410

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (34.8% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

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 Composite66/100

Would Recommend73%

Rated 9 or 10 (HCAHPS)69%

Median ER Wait226 min

Left ER Before Seen5%

30-Day Mortality vs U.S.better

Unplanned Readmissionsame

Hip/Knee Complication Rate3.5%

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 (2,139 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

Higher-Quality, Above-Median Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Lahey Hospital & Medical Center, Burlington.

Price Index: 1.08× regional baseline

Quality: 67/100 CMS composite

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 69/100 · Caution CMS CCN 220171 EIN 042704686

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 220171) ↗ Verify IRS Form 990 (EIN 042704686) ↗ CMS HCRIS Cost Reports ↗

Published MRF File042704686_lahey-hospital-medical-center-burlington_standardcharges.json

Publication / Vintage2026-04-01 · 23.62 MB

Validated Rate Rows401 (CMS v3.0.0)

File Integrity Digest6df4aa3f15bdcebba534…

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.

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