Price Transparency

The Centers for Medicare and Medicaid Services (CMS) requires hospitals to provide clear, easy-to-understand pricing information about the items and services they provide in two ways:

1. Provide information about the rates negotiated with insurance companies for all services and items offered by our hospitals. This information is not an estimate of the costs you are responsible for paying. The CMS-required hospital charge data files might not be the best tool for patients and families who are comparison shopping between hospitals and health systems for shoppable services. Please note: These are large files. You may need special computer software/speed to open the files.
2. Show shoppable services in a consumer-friendly way. CMS defines shoppable services as those that can be scheduled in advance. Hospitals must offer at least 300 shoppable services, including a pre-set list of 72 procedures.

Beth Israel Lahey Health offers a consumer-friendly online calculator to estimate the cost of out-of-pocket expenses for common exams, procedures, and tests, including the 300 shoppable services..

• Calculator for Current Patients
• Calculator for Prospective Patients

For more information about hospital costs, visit CompareCare, a website created by the Commonwealth for consumers to compare costs of medical procedures and quality metrics across Massachusetts.

As required by the federal government, we publish information about all services and items offered by our hospitals, plus:

• Rates negotiated with insurance companies
• Individual gross charge amounts

These amounts are almost never billed to you or received as payment by a hospital. The amounts are billed to an insurance company, Medicare or MassHealth. These payers then apply their reimbursement terms or contracted rates to the services billed, which is why these rates don’t generally reflect your out-of-pocket expenses.

If you owe a copayment, coinsurance or deductible, the charges often are based on payment terms set by your insurer or government program.

The CMS-required charge data file for Beth Israel Lahey Health hospitals don’t include services provided by physicians and/or other providers who aren’t employed by the hospital. The healthcare providers who may bill you separately include:

• Anesthesiologist
• Other physicians or staff who consulted on your care
• Radiologist who reads your X-rays or other imaging studies
• Surgeon who performs your procedure
• Your personal physician and/or provider

Yes, we use one list of costs for all patients. However, your health insurance coverage, other benefits and the services you receive will vary the cost of your care, such as:

• Differences in the specific services received
• How long it takes to perform the service
• How long it takes you to recover in the hospital
• Whether the service you receive is more or less difficult than expected
• The kinds of medication or supplies you require
• Whether you experience complications or require additional treatment

Yes. At Beth Israel Lahey Health, we recognize that not all patients have the resources to pay for the care they need, and we are committed to providing assistance and financial counseling. If you have limited or no insurance coverage, you may qualify for financial help through MassHealth, Commonwealth Care or Health Safety Net.

Our financial counselors can help you find the best ways to pay for your care. (For example, certain physicians are not covered under our financial assistance policies.) Check our financial assistance policy page for more information.