CMS Price Transparency Data

X-ray, hip

Facility: Calais Community Hospital

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73502
Insurance Median: $315
Cash Discount Price: $314
vs. Medicare Baseline: 3.54x Medicare

The contracted insurance negotiated median rate for a X-ray, hip at Calais Community Hospital is $315. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $314. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.54x the Medicare baseline. Located in 24 Hospital Lane, Calais, ME.

Cash / Self-Pay

$314

Average discount available for prompt cash payment at this facility.

Insurance Median

$315

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: $314 (353%)

Insurance Median: $315 (354%)

Cash: $314 (353% of Medicare)

Ins. Median: $315 (354% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 354% of the Medicare baseline (a markup of 254%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$80 - $358	90%
UnitedHealthcare	$80 - $388	90%
Humana	$169 - $198	190%
Wellcare	$169 - $198	190%
Partners Direct Health	$223 - $262	251%
Cigna	$324 - $379	364%
Aetna	$331 - $388	372%
Martins Point	$347 - $406	390%
Harvard Pilgrim	$352 - $413	396%

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 $314.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73502.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Calais Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73502.
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.