CMS Price Transparency Data

X-ray, foot

Facility: Mainehealth Pen Bay Hospital

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $69
Cash Discount Price: $226
vs. Medicare Baseline: 0.78x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Mainehealth Pen Bay Hospital is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $226. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.78x the Medicare baseline. Located in 6 Glen Cove Drive, Rockport, ME.

Cash / Self-Pay

$226

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $226 (254%)

Insurance Median: $69 (78%)

Cash: $226 (254% of Medicare)

Ins. Median: $69 (78% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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
Aetna	$8 - $497	9%
Blue Cross Blue Shield	$8 - $414	9%
Wellcare	$8 - $88	9%
Humana	$9 - $85	10%
UnitedHealthcare	$9 - $528	10%
Harvard Pilgrim Healthcare	$15 - $483	17%
Multiplan	$15 - $533	17%
Community Health Options	$16 - $449	18%
Cigna	$178 - $447	200%

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 $226.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73630.

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 73630.
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.