Spaulding Hospital for Continuing Medical Care - Cambridge
1575 Cambridge St, Cambridge, MA 02138 · 6 Priced Procedures
Typical commercial prices here are +219% above the fair benchmark (3.19×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Spaulding Hospital for Continuing Medical Care - Cambridge prices routine shoppable procedures near 2.8× Medicare (p50 2.65×) while skewing captive emergency, lab, and upper-quartile codes to 7.4× Medicare (p75 4.60×, +74% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.95× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (35.1% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (3.19× 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.
- Captive ER (4.1×) & laboratory (2.4×) services average 2.64× higher multiples than routine shoppable care (2.8×)
- Upper-quartile procedures (Q75 4.60×) jump +74% above the median procedure ratio (Q50 2.65×)
- Unnegotiated chargemaster list prices average 7.2× Medicare (19¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Spaulding Hospital for Continuing Medical Care - Cambridge
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 6 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | — | — |
| X-ray, neck (cervical spine) CPT Code: 72040 | $428 | 4.6× |
| X-ray, pelvis CPT Code: 72170 | $292 | 2.7× |
| X-ray, lower back CPT Code: 72110 | $218 | 1.9× |
| X-ray, chest (two views) CPT Code: 71046 | $144 | 1.5× |
| Blood test, basic metabolic panel CPT Code: 80048 | $63 | 7.0× |
Audit a Bill or Quote at Spaulding Hospital for Continuing Medical Care - Cambridge (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $41,334
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (35.1% of gross = $41,334).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Spaulding Hospital for Continuing Medical Care - Cambridge's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)
Your bill ($117,762) is $98,675 above the denoised Fair BaseRate ($19,087) and 8.3× the $14,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (35.1% 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.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Spaulding Hospital for Continuing Medical Care - Cambridge.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.