How many shoppable procedure prices are published for Melrosewakefield Healthcare?

Melrosewakefield Healthcare in Melrose, MA currently has 114 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Melrosewakefield Healthcare's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Melrosewakefield Healthcare's median negotiated commercial rate is 1.9× the regionally adjusted fair BaseRate benchmark.

What is Melrosewakefield Healthcare's CMS Care Compare overall star rating?

CMS Care Compare assigns Melrosewakefield Healthcare 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 Voluntary non-profit - Private 160 Beds · urban Updated: 4/1/2026

Melrosewakefield Healthcare

585 Lebanon Street, Melrose, MA 02176 · 114 Priced Procedures · 63% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

High Markup · Shop Alternatives

1.91×vs. Fair Market Price

Typical commercial prices here are +91% above the fair benchmark (1.91×) even after accounting for local nurse/doctor wages and patient complexity.

71/100 · Corroborated

71/100Self-Pay Cash Beats Insurance 15% of the Time

File Completeness56

Price Logic56

Peer Alignment81

Clean Billing73

Real Cash Discount100

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 1.91× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +25% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Melrosewakefield Healthcare prices routine shoppable procedures at 2.6× Medicare (median 2.22× Fair BaseRate) while upper-quartile commercial rates jump +25% to 2.77× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#47 of 53 in MA · 86th State Percentile#3,032 of 3,385 in U.S. · 89th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.20× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 15% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (63/100 safety score) with 63% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (50.3% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 2.2× markup over Medicare rates
Commercial insurance median sits at 2.22× Fair BaseRate (2.6× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.77×) jump +25% above the median procedure ratio (Q50 2.22×)
Unnegotiated chargemaster list prices average 4.3× Medicare (29¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.6× Medicare

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

Back-Door Captive & ER0.65× Divergence

1.7× Medicare

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

Quantile Tail Spread+25% Upper Tail

Q25 1.20× · Q50 2.22× · Q75 2.77×

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

2.6× MedicareFair

Outpatient Surgery & ORBack-Door Captive

2.2× MedicareFair

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

3.6× MedicareElevated

Back-Door Captive ER VisitsBack-Door Captive

2.4× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

2.6× MedicareFair

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

2.3× MedicareFair

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

15% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 63/100Elevated

Procedure Prices at Melrosewakefield Healthcare

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 114 published procedures.

Sort:

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`	$38,507	$28,022	$30,775	0.9×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$34,850	$20,557	$17,936	1.1×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$15,682	$16,967	$19,087	0.9×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$21,312	$16,850	$19,432	0.9×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$8,718	$6,985	$8,223	0.8×
Trauma team activation HCPCS Code: `G0390`	$3,228	$2,903	$1,453	2.0×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,111	$2,875	$1,021	unverified
Injection procedure for pain management HCPCS Code: `G0260`	$1,641	$1,886	$855	unverified
Upper endoscopy with biopsy CPT Code: `43239`	$1,472	$1,804	$987	1.8×
Colonoscopy with biopsy CPT Code: `45380`	$2,339	$1,771	$1,256	1.4×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,080	$1,543	$583	unverified
Blood transfusion CPT Code: `36430`	$935	$1,245	$498	2.5×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,291	$1,244	$448	unverified
Colonoscopy (diagnostic) CPT Code: `45378`	$2,525	$1,173	$981	1.2×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,298	$790	$303	unverified
MRI, brain (with and without contrast) CPT Code: `70553`	$2,351	$646	$511	1.3×
CT scan, head (with contrast) CPT Code: `70460`	$861	$549	$242	2.3×
CT scan, head (with and without contrast) CPT Code: `70470`	$793	$549	$258	2.1×
MRI, brain (no contrast) CPT Code: `70551`	$1,224	$489	$343	1.4×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$376	$454	$272	1.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$424	$386	$148	2.6×
MRI, lower back (no contrast) CPT Code: `72148`	$1,345	$408	$338	1.2×
Ultrasound, pelvis CPT Code: `76856`	$354	$368	$130	2.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$456	$363	$134	2.7×
CT scan, head (no contrast) CPT Code: `70450`	$1,050	$373	$160	2.3×
CT scan, chest (no contrast) CPT Code: `71250`	$1,340	$373	$167	2.2×
MRI, knee or other leg joint CPT Code: `73721`	$1,409	$395	$369	1.1×
X-ray, lower back CPT Code: `72110`	$294	$390	$112	unverified
CT scan, sinuses CPT Code: `70486`	$751	$353	$166	2.1×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$456	$353	$168	2.1×
Screening mammogram (both breasts) CPT Code: `77067`	$516	$319	$123	2.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$823	$344	$169	2.0×
CT scan, pelvis CPT Code: `72192`	$511	$316	$163	1.9×
X-ray, pelvis CPT Code: `72170`	$233	$333	$110	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$188	$268	$123	2.2×
Ultrasound, thyroid and neck CPT Code: `76536`	$304	$279	$132	2.1×
Psychotherapy session (60 minutes) CPT Code: `90837`	$271	$271	$181	1.5×
Rabies immune globulin HCPCS Code: `90375`	$1,478	$280	$322	0.9×
X-ray, chest (two views) CPT Code: `71046`	$198	$283	$93	unverified
X-ray, neck (cervical spine) CPT Code: `72040`	$204	$283	$93	unverified
X-ray, hand CPT Code: `73130`	$250	$299	$93	unverified
X-ray, ankle CPT Code: `73610`	$250	$292	$93	unverified
X-ray, foot CPT Code: `73630`	$250	$292	$92	unverified
Psychiatric evaluation (first visit) CPT Code: `90791`	$269	$269	$185	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$151	$215	$87	2.5×
X-ray, hip CPT Code: `73502`	$161	$216	$93	2.3×
Ultrasound, abdomen (limited) CPT Code: `76705`	$266	$231	$126	1.8×
Speech therapy (language evaluation) CPT Code: `92507`	$257	$203	$86	2.4×
Breathing treatment (nebulizer) CPT Code: `94640`	$210	$210	$201	unverified
Physical therapy (functional capacity test) CPT Code: `97750`	$157	$157	$38	4.1×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$123	$176	$64	2.8×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$113	$121	$40	3.0×
X-ray, chest (single view) CPT Code: `71045`	$133	$146	$92	1.6×
X-ray, shoulder CPT Code: `73030`	$141	$141	$92	1.5×
Hepatitis B immune globulin HCPCS Code: `90371`	$348	$138	$151	0.9×
Hospital observation (per hour) HCPCS Code: `G0378`	$140	$140	$86	unverified
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$106	$94	$25	3.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$116	$109	$38	2.9×
Occupational therapy (self-care training) CPT Code: `97535`	$83	$105	$38	2.8×
Physical therapy (manual therapy) CPT Code: `97140`	$107	$124	$34	unverified
Physical therapy (gait training) CPT Code: `97116`	$133	$91	$33	2.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$116	$94	$35	2.7×
Diagnostic procedure preparation HCPCS Code: `G0279`	$78	$81	$35	2.3×
Prosthetic fitting and training CPT Code: `97761`	$86	$86	$45	1.9×
Orthotic fitting and training CPT Code: `97760`	$97	$97	$51	1.9×
Care planning with family CPT Code: `90887`	$97	$97	$107	unverified
Typhoid vaccine HCPCS Code: `90675`	$1,082	$370	$347	1.1×
Drug screening test HCPCS Code: `G0480`	$240	$240	$116	unverified
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$457	$196	$203	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$212	$212	$111	unverified
Blood antibody screen CPT Code: `86850`	$170	$175	$46	unverified
Pneumococcal vaccine HCPCS Code: `90732`	$412	$133	$140	0.9×
Pneumonia vaccine injection HCPCS Code: `G0009`	$112	$130	$49	unverified
Flu vaccine (high dose) HCPCS Code: `90656`	$103	$103	$25	unverified
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$118	$118	$39	unverified
Blood test, vitamin D CPT Code: `82306`	$73	$73	$31	2.4×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$93	$93	$56	unverified
Flu vaccine injection HCPCS Code: `G0008`	$112	$112	$48	unverified
Colorectal cancer screening HCPCS Code: `G0010`	$83	$83	$49	unverified
Electrical stimulation therapy HCPCS Code: `G0283`	$32	$39	$14	2.8×
Psychotherapy session (45 minutes) CPT Code: `90834`	$234	$47	$166	0.3×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$62	$62	$20	unverified
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$72	$72	$27	unverified
Blood test, vitamin B12 CPT Code: `82607`	$42	$42	$16	2.6×
Blood test, PSA (prostate screen) CPT Code: `84153`	$46	$46	$19	2.4×
Blood test, thyroid (TSH) CPT Code: `84443`	$43	$43	$18	2.4×
Blood test, calcium CPT Code: `82310`	$13	$13	$5	2.6×
Blood test, sodium CPT Code: `84295`	$13	$13	$5	2.6×
Blood test, amylase CPT Code: `82150`	$18	$18	$7	2.6×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$27	$27	$11	2.5×
Blood test, magnesium CPT Code: `83735`	$17	$17	$7	2.4×
Blood test, potassium CPT Code: `84132`	$12	$12	$5	2.4×
Blood test, complete blood count (CBC) CPT Code: `85025`	$19	$19	$8	2.4×
Culture, bacterial CPT Code: `87070`	$21	$21	$9	2.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	$32	$32	$14	2.3×
Culture, blood CPT Code: `87040`	$25	$25	$11	2.3×
Hepatitis B vaccine HCPCS Code: `90744`	$100	$33	$37	0.9×
New patient office visit (30-44 min) CPT Code: `99203`	$177	$38	$110	0.3×
Family therapy session CPT Code: `90847`	$263	$52	$173	0.3×
Group therapy session CPT Code: `90853`	$177	$27	$100	0.3×
Blood test, basic metabolic panel CPT Code: `80048`	$22	$22	$9	unverified
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$35	$35	$14	unverified
Blood test, liver function panel CPT Code: `80076`	$20	$20	$9	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$8	$8	$3	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$13	$13	$5	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$11	$11	$4	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$25	$25	$10	unverified
Blood test, lipase CPT Code: `83690`	$17	$17	$7	unverified
Hepatitis C antibody test CPT Code: `86803`	$37	$37	$15	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$11	$11	$4	unverified
Blood test, hemoglobin CPT Code: `85018`	$6	$6	$3	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$11	$11	$5	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	$15	$15	$6	unverified
Review of medical records for care CPT Code: `90889`	$25	$25	$114	unverified

Showing top 25 high-impact procedures of 114 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 50.3%

Audit a Bill or Quote at Melrosewakefield Healthcare (Zero PHI Required)

CMS CCN: 220070

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $38,507

Insurer Median $28,022

1. Amount on Your Bill or Quote ($) Pre-filled with Melrosewakefield Healthcare’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: $27,664 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $27,664

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (50.3% of gross = $27,664).

Step 2 · Cash vs. Insurance Arbitrage Save $16,502 Paying Cash

Self-Pay Cash Rate ($38,507) Beats Your Bill

Melrosewakefield Healthcare's published 45 CFR § 180 self-pay cash rate is $38,507 (vs. $28,022 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$24,234 Above Fair BaseRate

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

Your bill ($55,009) is $24,234 above the denoised Fair BaseRate ($30,775) and 2.3× 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)

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 (50.3% 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 Composite63/100

Would Recommend63%

Rated 9 or 10 (HCAHPS)68%

Median ER Wait199 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.6%

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

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Melrosewakefield Healthcare. Prior administrative notices do not necessarily reflect current compliance status.

2025-03-06·administrative_or_closure
Closure Notice
Recorded
2024-12-03·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (415 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 Value & Quality Leader

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Melrosewakefield Healthcare.

Price Index: 1.00× regional baseline

Quality: 59/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

WellSense

+109.0%

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 71/100 · Corroborated CMS CCN 220070

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

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 220070) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage4/1/2026

Validated Rate Rows13,470 (CMS v3.0.0)

File Integrity DigestVerified · CCN 220070

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