Clsd tx metatarsal fracture w/manip 28475 at Stephens Memorial Hospital
181 Main St, Norway, ME · MaineHealth · · NPI 1346299815
$536.50
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
?
What you pay up front if you don't use insurance.
$536.50
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
?
The hospital's undiscounted list price — almost no one pays this.
$166.78 with Humana vs $471.66 with Aetna — same scan, same building. Share
Negotiated rates by payer
?
Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
?
Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| Humana | Medicare Advantage | $166.78 | ↓ -69% |
| Aetna | Medicare Advantage | $166.78 | ↓ -69% |
| United Healthcare | Medicare Advantage | $166.78 | ↓ -69% |
| Anthem | Medicare Advantage | $171.79 | ↓ -68% |
| Wellcare | Medicare Advantage | $173.45 | ↓ -68% |
| Aetna | MHACO Government | $222.02 | ↓ -59% |
| Aetna | HMO/PPO | $294.29 | ↓ -45% |
| Harvard Pilgrim Healthcare | Maine's Choice | $373.34 | ↓ -30% |
| Cigna | Commercial | $398.57 | ↓ -26% |
| Anthem | HMO/POS/PPO Pathway Enhanced | $399.55 | ↓ -26% |
| Multiplan | Commercial | $401.99 | ↓ -25% |
| Community Health Options | Commercial | $406.27 | ↓ -24% |
| United Healthcare | Commercial | $410.54 | ↓ -23% |
| Harvard Pilgrim Healthcare | Commercial | $414.82 | ↓ -23% |
| Aetna | MHACO Commercial | $471.66 | ↓ -12% |
Visitor-reported prices
Comments
Clsd tx metatarsal fracture w/manip 28475 at other Maine hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Franklin Memorial Hospital | Farmington | $672.15 | $201.65 – $483.94 |
| Lincoln Health | Damariscotta | $572.30 | $217.47 – $484.74 |
| Pen Bay Medical Center | Rockport | $472.15 | $222.02 – $414.31 |
| Waldo County General Hospital | Belfast | $523.70 | $222.02 – $516.54 |
| Spring Harbor Hospital | Westbrook | not published | $228.18 – $516.54 |
| Mid Coast Hospital | Brunswick | not published | $222.02 – $516.54 |