Boston Medical Center-brighton

Boston Medical Center-Brighton, a for-profit hospital in Brighton, MA, charges 1.9x the Medicare reimbursement rate across 73 analyzed procedures.

Brighton, MA 02135 · Acute Care Hospitals · CMS Rating: 2/5

By Elena Vasquez , Medical Billing Research Lead · Published March 15, 2026 · Updated April 3, 2026

Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.

About the analyst

Elena Vasquez leads hospital billing pattern analysis at BillRazor Research. She focuses on identifying overcharges, markup outliers, and patient advocacy strategies. Expertise: hospital billing patterns, overcharge analysis, patient advocacy.

73 procedures analyzed

CMS price transparency data

Updated 2026-04-03

1.9x

Medicare markup ratio

MA lowestBoston Medical Center-...MA highest

1.9x

Avg markup ratio

1.8x

Median markup

Procedures

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Billing patterns — for-profit

For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.

Pricing grade

Excellent

Avg markup vs Medicare

1.9x

Charge / Medicare rate

Max markup

3.27x

Worst procedure

Procedures analyzed

With pricing data

Outlier procedures

Above 90th percentile

Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.

Procedure	Code	Gross charge	Cash price	Medicare	Markup
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC	267	$254,995	$127,498	—	3.3x
COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC	455	$160,485	$80,242	—	3.1x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC	247	$58,515	$29,258	—	3x
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC	266	$293,196	$146,598	—	3x
COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC	454	$243,557	$121,778	—	2.9x
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC	274	$97,846	$48,923	—	2.8x
KIDNEY AND URINARY TRACT INFECTIONS WITH MCC	689	$30,047	$15,024	—	2.8x
GASTROINTESTINAL HEMORRHAGE WITH MCC	377	$58,806	$29,403	—	2.8x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS	065	$24,957	$12,478	—	2.6x
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC	698	$42,273	$21,137	—	2.5x
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC	481	$50,012	$25,006	—	2.5x
DIGESTIVE MALIGNANCY WITH MCC	374	$45,724	$22,862	—	2.4x
AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC	269	$104,633	$52,316	—	2.4x
ATHEROSCLEROSIS WITHOUT MCC	303	$15,543	$7,771	—	2.3x
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	470	$42,780	$21,390	—	2.3x
COAGULATION DISORDERS	813	$39,872	$19,936	—	2.3x
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC	271	$90,344	$45,172	—	2.3x
PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC	243	$50,744	$25,372	—	2.3x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O	246	$73,736	$36,868	—	2.3x
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC	480	$70,578	$35,289	—	2.2x
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC	309	$14,569	$7,284	—	2.2x
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC	393	$36,312	$18,156	—	2.2x
OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC	091	$38,044	$19,022	—	2.1x
SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	460	$81,620	$40,810	—	2.1x
GASTROINTESTINAL HEMORRHAGE WITH CC	378	$21,127	$10,564	—	2.1x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC	281	$19,418	$9,709	—	2.1x
DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC	057	$26,229	$13,115	—	2.1x
OTHER VASCULAR PROCEDURES WITH CC	253	$61,185	$30,593	—	2x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC	064	$41,835	$20,918	—	2x
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC	871	$38,266	$19,133	—	1.9x
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC	853	$106,192	$53,096	—	1.9x
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC	391	$23,950	$11,975	—	1.9x
SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS	870	$126,311	$63,156	—	1.9x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC	286	$46,024	$23,012	—	1.9x
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC	435	$32,691	$16,346	—	1.8x
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC	236	$68,038	$34,019	—	1.8x
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION	220	$107,077	$53,539	—	1.8x
OTHER VASCULAR PROCEDURES WITH MCC	252	$61,688	$30,844	—	1.8x
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC	025	$79,385	$39,693	—	1.8x
HEART FAILURE AND SHOCK WITH MCC	291	$22,372	$11,186	—	1.8x
RENAL FAILURE WITH CC	683	$15,306	$7,653	—	1.8x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC	287	$19,122	$9,561	—	1.8x
ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA	894	$9,788	$4,894	—	1.8x
PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC	242	$59,928	$29,964	—	1.7x
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC	392	$12,393	$6,197	—	1.7x
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC	270	$85,945	$42,973	—	1.7x
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC	233	$137,663	$68,831	—	1.7x
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION	219	$138,098	$69,049	—	1.7x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC	280	$26,580	$13,290	—	1.7x
SEIZURES WITHOUT MCC	101	$13,831	$6,916	—	1.6x

Showing 50 of 73 procedures

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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

FAQ — for-profit hospital billing

How much do for-profit hospitals typically charge compared to Medicare rates?

Based on data from 628 for-profit hospitals, the average markup is 7.8 times Medicare rates. This means charges are typically set at nearly 8 times what Medicare would pay for the same services.

Why do for-profit hospitals charge more than Medicare rates?

For-profit hospitals operate as businesses with shareholders and must generate revenue to cover operational costs and profit margins. Their pricing structure differs from Medicare's standardized payment rates, which are set by government formula rather than market conditions.

Does insurance typically pay the full hospital charge amount?

Most insurance companies negotiate contracted rates with hospitals that are lower than the posted charges. However, patients may still face significant out-of-pocket costs depending on their insurance coverage and deductible amounts.

What should I know about billing differences between hospital types?

For-profit hospitals generally have different pricing structures than non-profit or government-owned facilities due to their business model. Understanding your hospital's ownership type can provide context for potential billing differences when reviewing medical bills.

Related pricing data

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Brighton, MA costsCity-level pricing data

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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.

Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.

This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use