Financial & Billing Matters | Standard Charges & Shoppable Services

The information provided is not intended to provide all of the information needed to estimate the cost of care. There may be other costs in providing your care (e.g., the cost of physician services) that are not included. This information may not reflect the amounts patients may be required to pay for services provided by Boston Children’s Hospital. For those covered under a health plan, the patient/family should contact their health plan for individual benefit-specific information about what services are covered and the applicable patient financial responsibility. In addition, for more detailed information about the amounts that may be charged in connection with your care or course of treatment, you may contact the Hospital’s Financial Assistance Counselors at 617-355-7201, or request an estimate of the cost for your care.

Services:

  • IP: Inpatient Hospital Service
  • OP: Outpatient Hospital Service
  • CHD ONC: Congenital Heart Disease and Oncology Hospital Services

Locations:

  • LW: Services provided at our main campus on Longwood Avenue in Boston and our location at Two Brookline Place in Brookline
  • SAT: Services provided at our Satellite Locations in Waltham, Lexington, Peabody, and North Dartmouth

Insurance Short Names:

  • GIC: Group Insurance Commission
  • PHCS: Private Healthcare System
  • BMCHP: Boston Medical Center Health Plan
  • FCHP: Fallon Community Health Plan

Payer Plan Product Types:

  • HMO: Healthcare Management Organization
  • PPO: Preferred Provider Organization
  • POS: Point of Service
  • Indem: Indemnity
  • COMM: Commercial
  • LOC: Local Members for Harvard Pilgrim
  • NAT: National Members for Harvard Pilgrim
  • FOC: Focus Network Members for Harvard Pilgrim
  • QHP: Qualified Health Plan
 

Boston Children’s Hospital Standard Charge Information

Download a list of inpatient or outpatient hospital services performed at Boston Children’s Hospital. The list includes the Hospital’s gross standard charges for these services, payer-specific negotiated charges, by payer and by plan offered (where applicable for inpatient and outpatient services), and de-identified minimum and maximum negotiated charges. The list is noted with an “I.C.” (Individual Consideration) for discounted cash prices, as discounts offered by the Hospital vary based on financial and other circumstances of the patient seeking a discount and—in some cases—care is provided at no charge to the patient. Please see the Hospital’s Financial Assistance Policy and Uninsured Patient Discount Policy for information on eligibility criteria, application and approval processes, and discounts available. Pharmacy items are priced at the time they are dispensed to patients, based on acquisition cost at the time they are dispensed, and may vary. Pharmacy prices shown in the list represent average prices and may differ from the charges reflected on a patient’s actual bill.

Certain items are listed with the code “I.C.” (Individual Consideration), which means the price may vary based on the services required for each patient, as determined by the patient’s physician.

The gross charges for all services and items are those in effect as of October 1, 2020, and the payer-specific negotiated charges are those in effect as of January 1, 2021.


Boston Children’s Hospital 300 Shoppable Services

Search a list of 300 shoppable services that may be scheduled in advance, which includes routine and/or ancillary services associated with the shoppable service for all locations. These 300 shoppable services represent 70 services identified by the Centers for Medicare & Medicaid Services (CMS), as well as 230 services most commonly provided by the Hospital. Included in the shoppable services are the average payer-specific negotiated charges for the services and average de-identified minimum and maximum negotiated charges.

The average payer-specific negotiated charges represent rates in effect as of January 1, 2021.

Certain items are listed with the code “I.C.” (Individual Consideration), which means the price may vary based on the services required for each patient, as determined by the patient’s physician.

The information included is not intended to provide all of the information needed to estimate the cost of care. For more information, you may contact the Hospital’s Financial Assistance Counselors at 617-355-7201 or request an estimate of the cost for your care.


Cash price for a COVID-19 diagnostic test

Should you wish to pay cash for a COVID-19 diagnostic test at Boston Children’s Hospital (BCH), the prices are as follows.

Test name
Boston Children’s Hospital cash price
COVID-19 RT-PCR (Hologic)
$186.00*
COVID-19 Flu and Respiratory Virus PCR (4 target)
$201.00*
COVID-19 RT-PCR (Altoona-BCH)
$238.00*
COVID-19 ANTIBODY
$90.00*


*You may be eligible for: (a) financial assistance under Boston Children's Hospital Financial Assistance Policy; (b) a discount under BCH’s Uninsured Patient Discount Policy; or (c) other assistance under federal and state COVID testing funding. Please contact our financial counselors at 617-355-7201 for assistance with determining coverage under your health plan, or eligibility for assistance in the absence of health plan coverage.