CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mainehealth Pen Bay Hospital

Billing Code: 73721 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$213

about 0.9× the $244 Medicare rate · typically $208–$428

modeled estimate · not a bill or quote

What this hospital charges insurers

$204

About the fair price

about $9 under the fair price · 0.8× Medicare

Medicare pays $244 Fair price $213 This hospital $204 Cash price $1,367 Hospital's list price $1,367

How we calculate the fair BaseRate →

How this hospital compares to other ME hospitals

One of the lower prices — 6 of 8 other ME hospitals charge more for the same procedure.

Cheapest $171 Priciest $231

Black dot = this hospital, among the 9 ME hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a MRI, knee or other leg joint is about $213 (about 0.9× the $244 Medicare rate). Mainehealth Pen Bay Hospital charges insurers about $204, or about $1,367 in cash — about the fair price. Located in Rockport, ME.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$71 - $1,312	29%
Blue Cross Blue Shieldmajor	$62 - $1,136	25%
Aetnamajor	$63 - $1,236	26%
Cignamajor	$1,078 - $1,112	442%
Humanamajor	$71 - $234	29%
Harvard Pilgrim	$123 - $1,200	50%
WellCare	$63 - $241	26%
+ 1 smaller / regional plan	$129 - $1,117

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,367), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 73721.

Insurance Before you use insurance

Call your insurance company to confirm Mainehealth Pen Bay Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 73721.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mainehealth Pen Bay Hospital

Compare: MRI, knee or other leg joint at other ME hospitals

Insurance negotiated median for the same procedure, sorted lowest first.