healthcosts.net
Pen Bay Medical Center
6 Glen Cove Dr, Rockport, ME · MaineHealth · · NPI 1982645305
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Abdominal CT scan (with and without contrast) CPT 74170 | $2,953.20 | $2,953.20 | $63.56 – $1,190.76 | 9 |
| Abdominal CT scan (with contrast) CPT 74160 | $2,306.60 | $2,306.60 | $57.98 – $1,046.17 | 9 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,920.60 | $1,920.60 | $54.17 – $680.00 | 9 |
| Abdominal MRI (with and without contrast) CPT 74183 | $3,085.40 | $3,085.40 | $100.57 – $1,938.49 | 9 |
| Abdominal MRI (with contrast) CPT 74182 | $2,864.05 | $2,864.05 | $78.73 – $2,259.74 | 9 |
| Abdominal MRI (without contrast) CPT 74181 | $2,001.60 | $2,001.60 | $66.39 – $1,281.97 | 9 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,453.60 | $1,453.60 | $36.91 – $729.51 | 9 |
| Abdominal Ultrasound (limited) CPT 76705 | $1,051.40 | $1,051.40 | $26.87 – $665.99 | 9 |
| Allergy Skin Testing CPT 95004 | not published | not published | $3.51 – $7.46 | 8 |
| Ankle X-ray CPT 73610 | $566.90 | $566.90 | $8.08 – $187.35 | 9 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | not published | not published | $84.23 – $224.22 | 5 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | not published | not published | $91.30 – $238.36 | 5 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | not published | not published | $92.21 – $248.63 | 5 |
| Annual Physical, New Patient (age 40-64) CPT 99386 | not published | not published | $111.84 – $286.53 | 5 |
| Appendix Removal (Laparoscopic) CPT 44970 | not published | not published | $574.13 – $1,239.70 | 8 |
| Blood Clotting (PT/INR) Test CPT 85610 | $110.55 | $110.55 | $4.29 – $85.16 | 9 |
| Blood Clotting (PTT) Test CPT 85730 | $190.05 | $190.05 | $6.01 – $178.65 | 9 |
| Blood Count (CBC) Test CPT 85025 | $105.05 | $105.05 | $7.77 – $98.75 | 9 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $79.70 | $79.70 | $6.47 – $74.92 | 9 |
| Blood Culture Test CPT 87040 | $399.85 | $399.85 | $10.32 – $375.86 | 9 |
| Bone Density Scan (DEXA) CPT 77080 | $247.00 | $247.00 | $9.06 – $173.19 | 9 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $4,634.85 | $4,634.85 | $67.38 – $3,656.90 | 9 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $3,216.30 | $3,216.30 | $54.49 – $2,537.66 | 9 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $2,772.30 | $2,772.30 | $54.49 – $1,486.63 | 9 |
| Brain MRI (with and without contrast) CPT 70553 | $2,174.90 | $2,174.90 | $104.71 – $1,664.43 | 9 |
| Brain MRI (with contrast) CPT 70552 | $1,846.40 | $1,846.40 | $81.36 – $1,455.59 | 9 |
| Brain MRI (without contrast) CPT 70551 | $1,330.10 | $1,330.10 | $67.38 – $1,022.27 | 9 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $5,542.20 | $5,542.20 | $145.07 – $950.85 | 9 |
| C-Section Delivery (full care) CPT 59510 | not published | not published | $2,515.23 – $5,482.73 | 8 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $2,229.85 | $2,229.85 | $100.12 – $1,317.27 | 9 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $5,904.85 | $5,904.85 | $83.09 – $2,097.79 | 9 |
| CT Angiogram of the Head CPT 70496 | $5,904.85 | $5,904.85 | $79.72 – $2,097.79 | 9 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $5,109.95 | $5,109.95 | $91.62 – $1,601.43 | 9 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $4,088.20 | $4,088.20 | $83.43 – $1,413.26 | 9 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $3,679.25 | $3,679.25 | $79.39 – $910.39 | 9 |
| Cardiac Stress Test CPT 93015 | not published | not published | $67.80 – $148.44 | 8 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $1,673.55 | $1,673.55 | $36.02 – $1,110.48 | 9 |
| Carpal Tunnel Release Surgery CPT 64721 | not published | not published | $420.72 – $914.34 | 9 |
| Cataract Surgery CPT 66984 | not published | not published | $519.50 – $1,093.29 | 8 |
| Chest CT scan (with and without contrast) CPT 71270 | $2,953.20 | $2,953.20 | $57.00 – $2,090.26 | 9 |
| Chest CT scan (with contrast) CPT 71260 | $2,306.60 | $2,306.60 | $53.19 – $891.41 | 9 |
| Chest CT scan (without contrast) CPT 71250 | $1,920.60 | $1,920.60 | $49.25 – $738.94 | 9 |
| Chest X-ray CPT 71046 | $726.10 | $726.10 | $10.05 – $308.81 | 9 |
| Chest X-ray (single view) CPT 71045 | $685.65 | $685.65 | $8.41 – $273.03 | 9 |
| Cholesterol (Lipid) Test CPT 80061 | $201.65 | $201.65 | $13.39 – $189.55 | 9 |
| Circumcision (newborn) CPT 54150 | $709.90 | $709.90 | $91.35 – $230.21 | 9 |
| Colonoscopy (diagnostic) CPT 45378 | not published | not published | $87.72 – $654.68 | 9 |
| Colonoscopy (with biopsy) CPT 45380 | not published | not published | $190.18 – $834.57 | 9 |
| Colonoscopy (with polyp removal) CPT 45385 | not published | not published | $239.99 – $873.75 | 9 |
| Cystoscopy (Bladder Scope) CPT 52000 | $1,610.20 | $1,610.20 | $76.33 – $461.94 | 9 |
| Diabetes (HbA1c) Test CPT 83036 | $30.25 | $30.25 | $9.71 – $28.44 | 9 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $855.70 | $855.70 | $45.43 – $312.29 | 9 |
| Diagnostic Mammogram (one breast) CPT 77065 | $692.45 | $692.45 | $36.91 – $220.56 | 9 |
| EKG (Electrocardiogram) CPT 93000 | not published | not published | $13.83 – $29.15 | 8 |
| ER Visit (level 1, minor) CPT 99281 | $214.05 | $214.05 | $10.80 – $92.43 | 9 |
| ER Visit (level 2) CPT 99282 | $351.30 | $351.30 | $39.80 – $126.20 | 9 |
| ER Visit (level 3) CPT 99283 | $926.75 | $926.75 | $67.28 – $195.70 | 9 |
| ER Visit (level 4) CPT 99284 | $1,754.55 | $1,754.55 | $114.57 – $291.55 | 9 |
| ER Visit (level 5, high severity) CPT 99285 | $3,306.00 | $3,306.00 | $166.01 – $460.93 | 9 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $1,780.25 | $1,780.25 | $65.75 – $912.64 | 9 |
| Established Patient Office Visit (level 1) CPT 99211 | $191.65 | $191.65 | $8.41 – $44.97 | 9 |
| Established Patient Office Visit (level 2) CPT 99212 | $352.80 | $352.80 | $33.86 – $87.69 | 9 |
| Established Patient Office Visit (level 3) CPT 99213 | $352.80 | $352.80 | $63.46 – $122.21 | 9 |
| Established Patient Office Visit (level 4) CPT 99214 | $360.30 | $360.30 | $93.38 – $135.74 | 9 |
| Established Patient Office Visit (level 5) CPT 99215 | $608.65 | $608.65 | $124.73 – $173.76 | 9 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | $53.63 – $359.14 | 9 |
| Foot X-ray CPT 73630 | $566.90 | $566.90 | $7.76 – $178.08 | 9 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $628.64 – $1,359.67 | 8 |
| Hand X-ray CPT 73130 | $533.10 | $533.10 | $8.08 – $181.94 | 9 |
| Head CT scan (with and without contrast) CPT 70470 | $2,725.05 | $2,725.05 | $57.98 – $2,090.26 | 9 |
| Head CT scan (with contrast) CPT 70460 | $2,233.90 | $2,233.90 | $51.54 – $1,721.95 | 9 |
| Head CT scan (without contrast) CPT 70450 | $1,746.45 | $1,746.45 | $38.87 – $1,335.54 | 9 |
| Hernia Repair (Inguinal) CPT 49505 | not published | not published | $500.27 – $1,080.41 | 8 |
| Hip X-ray CPT 73502 | $430.50 | $430.50 | $10.37 – $158.00 | 9 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $978.55 | $978.55 | $33.63 – $729.51 | 9 |
| Knee Arthroscopy (Cartilage Repair) CPT 29877 | not published | not published | $598.53 – $1,291.88 | 8 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | not published | not published | $521.96 – $1,127.87 | 8 |
| Knee MRI (with and without contrast) CPT 73723 | $2,861.30 | $2,861.30 | $98.60 – $2,133.34 | 9 |
| Knee MRI (with contrast) CPT 73722 | $2,376.80 | $2,376.80 | $74.27 – $1,733.67 | 9 |
| Knee MRI (without contrast) CPT 73721 | $1,409.10 | $1,409.10 | $61.92 – $1,078.33 | 9 |
| Knee X-ray CPT 73564 | $604.60 | $604.60 | $10.71 – $245.54 | 9 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,407.45 | $1,407.45 | $30.89 – $967.98 | 9 |
| Liver Function Test CPT 80076 | $203.95 | $203.95 | $8.17 – $191.71 | 9 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,953.20 | $2,953.20 | $57.65 – $2,090.26 | 9 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,306.60 | $2,306.60 | $55.48 – $1,033.95 | 9 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,649.25 | $2,649.25 | $45.43 – $1,515.35 | 9 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,183.30 | $2,183.30 | $105.04 – $1,655.87 | 9 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,854.70 | $1,854.70 | $81.79 – $1,437.64 | 9 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,293.45 | $1,293.45 | $67.70 – $1,007.40 | 9 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $804.45 | $804.45 | $10.37 – $208.18 | 9 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $1,501.52 – $3,255.47 | 8 |
| Lung Function Test (Spirometry) CPT 94010 | $332.00 | $332.00 | $7.76 – $247.19 | 9 |
| Metabolic Blood Panel (Basic) CPT 80048 | $196.30 | $196.30 | $8.46 – $184.52 | 9 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $204.95 | $204.95 | $10.56 – $192.65 | 9 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $2,953.20 | $2,953.20 | $57.65 – $2,090.26 | 9 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $2,306.60 | $2,306.60 | $55.48 – $1,762.55 | 9 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $1,920.60 | $1,920.60 | $45.43 – $836.93 | 9 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $2,187.60 | $2,187.60 | $105.04 – $1,666.57 | 9 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $1,878.55 | $1,878.55 | $82.11 – $1,464.23 | 9 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $1,293.45 | $1,293.45 | $67.70 – $1,007.40 | 9 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $4,634.85 | $4,634.85 | $82.01 – $2,282.46 | 9 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $3,472.70 | $3,472.70 | $68.36 – $2,739.96 | 9 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $2,772.30 | $2,772.30 | $54.82 – $1,495.67 | 9 |
| New Patient Office Visit (level 2) CPT 99202 | $352.80 | $352.80 | $45.11 – $89.84 | 9 |
| New Patient Office Visit (level 3) CPT 99203 | $352.80 | $352.80 | $78.52 – $151.35 | 9 |
| New Patient Office Visit (level 4) CPT 99204 | $352.80 | $352.80 | $124.73 – $246.72 | 9 |
| New Patient Office Visit (level 5) CPT 99205 | $392.80 | $392.80 | $124.73 – $331.63 | 9 |
| Nuclear Stress Test (Heart) CPT 78452 | $3,916.80 | $3,916.80 | $72.51 – $2,525.12 | 9 |
| PSA (Prostate) Test CPT 84153 | $128.25 | $128.25 | $18.39 – $38.59 | 9 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,953.20 | $2,953.20 | $55.48 – $1,179.67 | 9 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,306.60 | $2,306.60 | $52.85 – $1,023.81 | 9 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,920.60 | $1,920.60 | $49.58 – $662.17 | 9 |
| Pelvic MRI (with and without contrast) CPT 72197 | $3,071.90 | $3,071.90 | $100.57 – $1,934.19 | 9 |
| Pelvic MRI (with contrast) CPT 72196 | $2,557.70 | $2,557.70 | $78.73 – $2,018.03 | 9 |
| Pelvic MRI (without contrast) CPT 72195 | $2,217.55 | $2,217.55 | $66.72 – $1,437.76 | 9 |
| Pelvic Ultrasound (complete) CPT 76856 | $1,453.60 | $1,453.60 | $31.45 – $729.51 | 9 |
| Pelvic Ultrasound (limited) CPT 76857 | $668.10 | $668.10 | $22.71 – $44.07 | 9 |
| Postpartum Care Only CPT 59430 | not published | not published | $165.94 – $513.33 | 9 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $1,453.60 | $1,453.60 | $45.76 – $729.51 | 9 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $1,453.60 | $1,453.60 | $45.43 – $553.40 | 9 |
| Prenatal Care Only (4-6 visits) CPT 59425 | not published | not published | $402.76 – $1,092.19 | 9 |
| Prenatal Care Only (7+ visits) CPT 59426 | not published | not published | $738.73 – $1,998.07 | 9 |
| Rapid Strep Test CPT 87880 | $49.15 | $49.15 | $16.53 – $46.20 | 9 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $87.72 – $655.32 | 8 |
| Screening Colonoscopy (high risk) HCPCS G0105 | not published | not published | $87.51 – $654.68 | 8 |
| Screening Mammogram CPT 77067 | $869.25 | $869.25 | $34.95 – $280.02 | 9 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $1,027.33 – $2,200.81 | 8 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,850.55 | $2,850.55 | $98.60 – $2,136.61 | 9 |
| Shoulder MRI (with contrast) CPT 73222 | $2,339.00 | $2,339.00 | $74.27 – $1,722.62 | 9 |
| Shoulder MRI (without contrast) CPT 73221 | $1,406.40 | $1,406.40 | $61.92 – $1,078.33 | 9 |
| Shoulder X-ray CPT 73030 | $437.25 | $437.25 | $8.74 – $174.13 | 9 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,953.20 | $2,953.20 | $57.65 – $2,090.26 | 9 |
| Sinus CT scan (with contrast) CPT 70487 | $2,306.60 | $2,306.60 | $51.54 – $760.12 | 9 |
| Sinus CT scan (without contrast) CPT 70486 | $1,920.60 | $1,920.60 | $39.21 – $631.00 | 9 |
| Skin Biopsy CPT 11102 | $378.65 | $378.65 | $36.08 – $194.03 | 9 |
| Sleep Study (Polysomnography) CPT 95810 | $5,591.75 | $5,591.75 | $112.82 – $2,613.88 | 9 |
| Thyroid (TSH) Test CPT 84443 | $214.55 | $214.55 | $16.80 – $201.68 | 9 |
| Thyroid Ultrasound CPT 76536 | $1,015.05 | $1,015.05 | $25.88 – $49.75 | 9 |
| Tonsillectomy (age 12+) CPT 42826 | not published | not published | $248.12 – $530.04 | 8 |
| Tonsillectomy (child under 12) CPT 42825 | not published | not published | $260.52 – $557.83 | 8 |
| Total Hip Replacement CPT 27130 | not published | not published | $1,230.66 – $2,638.68 | 8 |
| Total Knee Replacement CPT 27447 | not published | not published | $1,229.50 – $2,635.28 | 8 |
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $357.00 – $760.50 | 8 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $2,191.75 | $2,191.75 | $105.04 – $1,668.74 | 9 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $1,864.50 | $1,864.50 | $81.36 – $1,445.05 | 9 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $1,296.25 | $1,296.25 | $67.70 – $1,007.40 | 9 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $116.72 – $554.44 | 9 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $131.24 – $724.70 | 9 |
| Urinalysis (with microscopy) CPT 81001 | $150.20 | $150.20 | $3.17 – $141.19 | 9 |
| Urinalysis (without microscopy) CPT 81003 | $59.35 | $59.35 | $2.25 – $55.79 | 9 |
| Urine Culture Test CPT 87086 | $120.00 | $120.00 | $8.07 – $112.80 | 9 |
| Vaginal Delivery (full care) CPT 59400 | not published | not published | $2,276.07 – $4,935.74 | 8 |
| Vasectomy CPT 55250 | not published | not published | $220.27 – $648.25 | 9 |
| Vitamin D Test CPT 82306 | $167.40 | $167.40 | $29.60 – $157.36 | 9 |
| Wrist X-ray CPT 73110 | $533.10 | $533.10 | $8.08 – $210.03 | 9 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.