CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mainehealth Pen Bay Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $385
Cash Discount Price: $1,367
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mainehealth Pen Bay Hospital is $385. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,367. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.58x the Medicare baseline. Located in 6 Glen Cove Drive, Rockport, ME.

Cash / Self-Pay

$1,367

Average discount available for prompt cash payment at this facility.

Insurance Median

$385

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $1,367 (561%)

Insurance Median: $385 (158%)

Cash: $1,367 (561% of Medicare)

Ins. Median: $385 (158% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$62 - $1,136	25%
Aetna	$63 - $1,236	26%
Wellcare	$63 - $241	26%
Humana	$71 - $234	29%
UnitedHealthcare	$71 - $1,312	29%
Multiplan	$120 - $1,325	49%
Harvard Pilgrim Healthcare	$123 - $1,200	50%
Community Health Options	$129 - $1,117	53%
Cigna	$1,078 - $1,112	442%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,367.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73721.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mainehealth Pen Bay Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73721.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.