healthcosts.net
Lumbar Spinal Fusion (single level) at Pen Bay Medical Center
6 Glen Cove Dr, Rockport, ME · MaineHealth · · NPI 1982645305
not published by hospital
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.
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What you pay up front if you don't use insurance.
not published by hospital
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.
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The hospital's undiscounted list price — almost no one pays this.
$1,501.52 with Anthem vs $3,255.47 with Community Health Options — same scan, same building. Share
Negotiated rates by payer
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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 →
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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 |
|---|---|---|---|
| Anthem | Medicare Advantage | $1,501.52 | — |
| Aetna | MHACO Government | $1,505.90 | — |
| Aetna | Medicare Advantage | $1,516.38 | — |
| Wellcare | Medicare Advantage | $1,531.25 | — |
| Humana | Medicare Advantage | $1,709.65 | — |
| United Healthcare | Medicare Advantage | $1,709.65 | — |
| Aetna | HMO/PPO | $2,033.67 | — |
| Anthem | HMO/POS/PPO/Pathway Enhanced | $2,525.07 | — |
| Multiplan | Commercial | $2,889.20 | — |
| United Healthcare | Commercial | $3,041.26 | — |
| Harvard Pilgrim Healthcare | Commercial | $3,070.34 | — |
| Harvard Pilgrim Healthcare | Maines Choice | $3,070.34 | — |
| Aetna | MHACO Commercial | $3,079.28 | — |
| Community Health Options | Commercial | $3,255.47 | — |
Visitor-reported prices
Comments
Lumbar Spinal Fusion (single level) at other Maine hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Franklin Memorial Hospital | Farmington | not published | $1,505.90 – $3,255.47 |
| Stephens Memorial Hospital | Norway | not published | $1,505.90 – $3,255.47 |
| Lincoln Health | Damariscotta | not published | $1,505.90 – $3,255.47 |
| Spring Harbor Hospital | Westbrook | not published | $1,486.65 – $3,239.21 |
| Waldo County General Hospital | Belfast | not published | $1,505.90 – $3,255.47 |
| Mid Coast Hospital | Brunswick | not published | $1,486.65 – $3,255.47 |