Office visit, established patient (30-39 min)
Facility: Mainehealth Pen Bay Hospital
Billing Code: 99214 (CPT)
This hospital's typical commercial price is $127 compared to the $128 fair price benchmark.
3-Star CMS clinical quality rating paired with 0.99× fair market pricing.
A typical price — 5 charge more and 3 charge less, among the 9 ME hospitals compared.
Black dot = this hospital, among the 9 ME hospitals with a price for this procedure. Full list below.
A fair price for a Office visit, established patient (30-39 min) is about $128 (about 0.9× the $136 Medicare rate). Mainehealth Pen Bay Hospital charges insurers about $127, or about $204 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
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 | $106 - $336 | 78% |
| Blue Cross Blue Shieldmajor | $93 - $606 | 69% |
| Aetnamajor | $94 - $316 | 69% |
| Cignamajor | $114 - $284 | 84% |
| Humanamajor | $106 - $125 | 78% |
| Harvard Pilgrim | $117 - $307 | 86% |
| WellCare | $95 - $128 | 70% |
| + 1 smaller / regional plan | $114 - $286 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Mainehealth Pen Bay Hospital
Compare: Office visit, established patient (30-39 min) at other ME hospitals
- Calais Community Hospital · Calais $42
- Millinocket Regional Hospital · Millinocket $93
- Northern Light Acadia Hospital · Bangor $121
- Mainehealth Mid Coast Hospital · Brunswick $128
- Mainehealth Franklin Hospital · Farmington $129
- Penobscot Valley Hospital · Lincoln $132
- Northern Maine Medical Center · Fort Kent $132
- Northern Light Blue Hill Memorial Hospital · Blue Hill $139
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Mainehealth Pen Bay Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $74
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $74).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Mainehealth Pen Bay Hospital's published 45 CFR § 180 self-pay cash rate is $204 (vs. $127 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $128 Fair BaseRate ($136 Medicare)
Your bill ($204) is $76 above the denoised Fair BaseRate ($128) and 1.5× the $136 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.