Clsd tx fx radius/ulna w/manip 25565 at MaineHealth - Memorial Hospital
3073 White Mountain Highway, North Conway, NH · MaineHealth · · NPI 1760436216
$1,528.90
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.
$1,528.90
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.
$169.47 with Humana vs $949.22 with Aetna — 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 | $169.47 | ↓ -89% |
| United Healthcare | Medicare Advantage | $169.47 | ↓ -89% |
| Aetna | Medicare Advantage | $169.47 | ↓ -89% |
| Anthem | Medicare Advantage | $174.56 | ↓ -89% |
| Wellcare | Medicare Advantage | $176.25 | ↓ -88% |
| Anthem | HMO/POS/PPO Pathway Enhanced | $397.91 | ↓ -74% |
| Community Health Options | Commercial | $398.76 | ↓ -74% |
| Harvard Pilgrim Healthcare | Maine's Choice | $417.70 | ↓ -73% |
| Cigna | Commercial | $419.69 | ↓ -73% |
| Aetna | HMO/PPO | $431.51 | ↓ -72% |
| Harvard Pilgrim Healthcare | Maines Choice | $432.02 | ↓ -72% |
| Aetna | MHACO Government | $455.24 | ↓ -70% |
| Harvard Pilgrim Healthcare | Commercial | $464.06 | ↓ -70% |
| Multiplan | Commercial | $468.54 | ↓ -69% |
| United Healthcare | Commercial | $468.54 | ↓ -69% |
| Harvard Pilgrim Healthcare | Fully Insured | $477.71 | ↓ -69% |
| Aetna | HMO | $488.34 | ↓ -68% |
| Cigna | OAP | $493.33 | ↓ -68% |
| Aetna | PPO | $504.61 | ↓ -67% |
| Cigna | PPO | $505.08 | ↓ -67% |
| Harvard Pilgrim Healthcare | Self-Insured | $523.34 | ↓ -66% |
| Anthem | HMO/POS/PPO/Pathway Enhanced | $938.14 | ↓ -39% |
| Aetna | MHACO Commercial | $949.22 | ↓ -38% |