healthcosts.net
Established Patient Office Visit (level 5) at Stephens Memorial Hospital
181 Main St, Norway, ME · MaineHealth · · NPI 1346299815
$464.00
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.
$464.00
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.
$139.76 with Aetna vs $348.21 with Harvard Pilgrim Healthcare — 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 |
|---|---|---|---|
| Aetna | MHACO Government | $139.76 | ↓ -70% |
| Anthem | Medicare Advantage | $139.76 | ↓ -70% |
| Aetna | Medicare Advantage | $160.72 | ↓ -65% |
| Humana | Medicare Advantage | $160.72 | ↓ -65% |
| United Healthcare | Medicare Advantage | $160.72 | ↓ -65% |
| Wellcare | Medicare Advantage | $167.15 | ↓ -64% |
| Aetna | HMO/PPO | $191.30 | ↓ -59% |
| Anthem | HMO/POS/PPO Pathway Enhanced | $213.42 | ↓ -54% |
| Multiplan | Commercial | $259.46 | ↓ -44% |
| United Healthcare | Commercial | $273.12 | ↓ -41% |
| Aetna | MHACO Commercial | $285.10 | ↓ -39% |
| Community Health Options | Commercial | $290.78 | ↓ -37% |
| Cigna | Commercial | $322.16 | ↓ -31% |
| Harvard Pilgrim Healthcare | Commercial | $348.21 | ↓ -25% |
| Harvard Pilgrim Healthcare | Maine's Choice | $348.21 | ↓ -25% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 5) at other Maine hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Franklin Memorial Hospital | Farmington | $474.50 | $115.85 – $322.16 |
| Lincoln Health | Damariscotta | $962.80 | $139.76 – $348.21 |
| Pen Bay Medical Center | Rockport | $608.65 | $124.73 – $173.76 |
| Spring Harbor Hospital | Westbrook | $328.45 | $136.93 – $348.21 |
| Waldo County General Hospital | Belfast | $381.95 | $23.32 – $54.68 |
| Mid Coast Hospital | Brunswick | $396.35 | $125.85 – $290.78 |