healthcosts.net
Prolng off/op e/m ea 15 min 99417 at MaineHealth - Memorial Hospital
3073 White Mountain Highway, North Conway, NH · MaineHealth · · NPI 1760436216
$61.25
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.
$61.25
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.
$28.44 with United Healthcare vs $64.93 with Anthem — 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 |
|---|---|---|---|
| United Healthcare | Medicare Advantage | $28.44 | ↓ -54% |
| Anthem | Medicare Advantage | $28.72 | ↓ -53% |
| Aetna | Medicare Advantage | $29.01 | ↓ -53% |
| Aetna | MHACO Government | $29.49 | ↓ -52% |
| Humana | Medicare Advantage | $32.71 | ↓ -47% |
| Wellcare | Medicare Advantage | $32.71 | ↓ -47% |
| Aetna | HMO | $40.53 | ↓ -34% |
| Aetna | HMO/PPO | $40.53 | ↓ -34% |
| Aetna | PPO | $40.53 | ↓ -34% |
| Anthem | HMO/POS/PPO Pathway Enhanced | $50.15 | ↓ -18% |
| United Healthcare | Commercial | $53.25 | ↓ -13% |
| Multiplan | Commercial | $55.39 | ↓ -10% |
| Cigna | Commercial | $55.66 | ↓ -9% |
| Cigna | OAP | $55.66 | ↓ -9% |
| Cigna | PPO | $55.66 | ↓ -9% |
| Harvard Pilgrim Healthcare | Maines Choice | $59.11 | ↓ -3% |
| Harvard Pilgrim Healthcare | Commercial | $59.11 | ↓ -3% |
| Harvard Pilgrim Healthcare | Fully Insured | $59.11 | ↓ -3% |
| Harvard Pilgrim Healthcare | Maine's Choice | $59.11 | ↓ -3% |
| Harvard Pilgrim Healthcare | Self-Insured | $59.11 | ↓ -3% |
| Aetna | MHACO Commercial | $59.25 | ↓ -3% |
| Community Health Options | Commercial | $60.33 | ↓ -2% |
| Anthem | HMO/POS/PPO/Pathway Enhanced | $64.93 | ↑ +6% |