Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at Pen Bay Medical Center
6 Glen Cove Dr, Rockport, ME · MaineHealth · · NPI 1982645305
$179.35
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.
$179.35
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.
$50.44 with Humana vs $132.04 with Cigna — 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 |
|---|---|---|---|
| Humana | Medicare Advantage | $50.44 | ↓ -72% |
| United Healthcare | Medicare Advantage | $50.44 | ↓ -72% |
| Anthem | Medicare Advantage | $50.94 | ↓ -72% |
| Aetna | MHACO Government | $51.22 | ↓ -71% |
| Aetna | Medicare Advantage | $51.45 | ↓ -71% |
| Wellcare | Medicare Advantage | $51.95 | ↓ -71% |
| Anthem | HMO/POS/PPO/Pathway Enhanced | $59.21 | ↓ -67% |
| Aetna | HMO/PPO | $69.95 | ↓ -61% |
| Multiplan | Commercial | $99.90 | ↓ -44% |
| Harvard Pilgrim Healthcare | Maines Choice | $100.87 | ↓ -44% |
| Harvard Pilgrim Healthcare | Commercial | $100.87 | ↓ -44% |
| Community Health Options | Commercial | $105.07 | ↓ -41% |
| United Healthcare | Commercial | $105.16 | ↓ -41% |
| Aetna | MHACO Commercial | $106.47 | ↓ -41% |
| Cigna | Commercial | $132.04 | ↓ -26% |
Visitor-reported prices
Comments
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at other Maine hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Franklin Memorial Hospital | Farmington | $71.50 | $21.45 – $67.21 |
| Stephens Memorial Hospital | Norway | $188.00 | $51.22 – $175.22 |
| Lincoln Health | Damariscotta | $210.55 | $51.22 – $191.18 |
| Spring Harbor Hospital | Westbrook | $154.65 | $50.44 – $106.41 |
| Waldo County General Hospital | Belfast | $160.60 | $51.22 – $151.29 |
| Mid Coast Hospital | Brunswick | $179.35 | $50.44 – $117.38 |