Does Portsmouth Regional Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Portsmouth Regional Hospital. In a medical emergency, call 911.

Where is Portsmouth Regional Hospital?

333 Borthwick Ave, Portsmouth, NH 03801, in Rockingham County, New Hampshire.

What is the phone number of Portsmouth Regional Hospital?

(603) 436-5110, as listed by Medicare (CMS).

What is the Medicare star rating of Portsmouth Regional Hospital?

3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Portsmouth Regional Hospital — Portsmouth, NH

Quick answers

Does Portsmouth Regional Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Portsmouth Regional Hospital. In a medical emergency, call 911.
Where is Portsmouth Regional Hospital?: 333 Borthwick Ave, Portsmouth, NH 03801, in Rockingham County, New Hampshire.
What is the phone number of Portsmouth Regional Hospital?: (603) 436-5110, as listed by Medicare (CMS).
What is the Medicare star rating of Portsmouth Regional Hospital?: 3 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^{[5][6][8][16][17][25]}

Allergy treatment
Cardiology
Dermatology
Diagnostics and laboratory
Ear, nose and throat
Emergency care
Gastroenterology
ICU
Imaging services
Integrative medicine
Interventional radiology
Mental health and wellness
Nephrology
Neurological care
Nutrition services
Occupational medicine
Oncology
Orthopedic care
Outpatient physical rehabilitation
Pain management
Palliative care
Pediatrics
Pulmonary care
Sleep disorders
Surgery
Urology
Weight loss surgery
Weight management
Women's care
Wound care
Cancer care
Labor and delivery
Breast health

Treatments^{[5][9][11][13][14][16][23]}

Radiation therapy
Neurological rehabilitation
Pediatric rehabilitation
Deep brain stimulation
Chemotherapy
Photodynamic therapy for esophageal cancer
Physical therapy
Occupational therapy
Speech therapy
Cardiac rehabilitation
Pulmonary rehabilitation

Procedures^{[5][9][10][13][14][15][16][23][24][25]}

Cardiac catheterization
Heart and vascular surgery
Hip replacement
Knee replacement
Shoulder replacement
Minimally invasive surgery
Coronary artery bypass graft
Coronary angioplasty
Transcatheter aortic valve replacement
Balloon valvoplasty
Mitral valve surgery
Extracorporeal membrane oxygenation (ECMO)
Transcarotid artery revascularization
Endarterectomy
Abdominal aortic aneurysm repair
Coil embolization
Flow diversion stent
Cerebral angiography
Robot-assisted surgery
Laparoscopic surgery
Hernia repair
Gallbladder removal
Appendix removal
Hysterectomy
Spinal fusion
Sentinel node biopsy
3T MRI
CT scan
PET scan
3D mammography
Breast MRI
Image-guided breast biopsy
Echocardiogram
Electrocardiogram (EKG)
Electrophysiology (EP) study
Stress test
Holter monitoring

Programs and centers^{[5][6][8][10][11][13][17][18][19][21][23][25]}

Cardiac rehabilitation
Cancer clinical trials
Labor and delivery
Doula services
Pediatric ER
FastTrack ER
Level II Trauma Center
Comprehensive Stroke Center
Chest pain center
Level II NICU
TeamBirth
Brain aneurysm clinic
Deep brain stimulation program for movement disorders
The Heart and Vascular Institute
The Breast Center
Center for Rehabilitation and Wellness
Children's Rehabilitation Center
Inpatient mental health program
Partial hospitalization program

Emergency care (hospital website)^[6][18][19]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level II
Stroke designation	Comprehensive Stroke Center (DNV)

Visiting and practical information

Visiting	Visiting hours vary by unit; contact the unit nurse's station. ICU has special guidelines; behavioral health visits arranged in advance^[7]
Interpreters and languages	Free sign language and oral interpreters and other auxiliary aids for the inpatient behavioral health unit, on request^[21]

Recognition^{[4][6][8][13][15][18][25]}

Level II Trauma Center (verified by the American College of Surgeons)
Chest pain center accredited by the American College of Cardiology
Bariatric surgery accreditation (ACS Bariatric Surgery Center Network)
Cancer care center accreditation (American College of Surgeons)
Cardiac and Pulmonary Rehabilitation certification (AACVPR)
Echocardiography laboratory accreditation (ICAEL)
Laboratory accreditation (College of American Pathologists)
Comprehensive Stroke Center (DNV Healthcare)
Accredited chest pain center (American College of Cardiology)
American College of Radiology accreditation for mammography unit
Bariatric surgery program accreditation (American College of Surgeons)
American College of Surgeons accreditation for cancer care center
Designated Comprehensive Breast Imaging Center (ACR)
National Accreditation Program for Breast Centers (NAPBC)

Doctors and clinicians (694)

694 doctors and other clinicians list Portsmouth Regional Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 670 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

York Hospital8.9 mi · York, ME · Acute Care Hospital
Exeter Hospital Inc9.1 mi · Exeter, NH · Acute Care Hospital
Wentworth-Douglass Hospital11 mi · Dover, NH · Acute Care Hospital
Anna Jaques Hospital18 mi · Newburyport, MA · Acute Care Hospital
Frisbie Memorial Hospital19 mi · Rochester, NH · Acute Care Hospital

Other hospitals nearby

Whittier Pavilion24 mi · Haverhill, MA · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

The Edgewood Centre1.4 mi · Portsmouth, NH · 3 of 5 stars
Cedar Healthcare Center1.7 mi · Portsmouth, NH · 5 of 5 stars
Webster at Rye4.0 mi · Rye, NH · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Beacon Hospice, An Amedisys Company1.1 mi · Portsmouth, NH · 4 of 5 stars
Unity Hospice, LLC7.4 mi · Durham, NH
Beth Israel Lahey Health at Home11 mi · Exeter, NH · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Amedisys Home Health1.1 mi · Portsmouth, NH
Tufts Medicine Care at Home - Home Health NH6.1 mi · North Hampton, NH · 4 of 5 stars
Pathways Healthcare, LLC9.1 mi · York, ME · 3 of 5 stars

All home health agencies in the state →

Dialysis facilities

FMC Seacoast Dialysis Center1.1 mi · Portsmouth, NH · 4 of 5 stars
Fresenius Medical Care of Cocheco River9.7 mi · Dover, NH · 2 of 5 stars
FMC Dialysis Services of Exeter11 mi · Exeter, NH · 5 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

Coastal Surgical Center LLC1.1 mi · Newington, NH
New England Center for Orthopaedic Surgery1.1 mi · Portsmouth, NH
Pain Surgery Center Limited Liability Company1.1 mi · Newington, NH

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Cross Roads House1.2 mi · Portsmouth, NH · Community health center
Greater Seacoast Health1.2 mi · Portsmouth, NH · Community health center
Greater Seacoast Community Health3.2 mi · Greenland, NH · Community health center

Clinics and urgent care

Convenientmd - FFS UC LLC1.1 mi · Portsmouth, NH · Urgent care center
Convenientmd - FFS UC LLC6.6 mi · Stratham, NH · Urgent care center
Convenientmd - FFS UC LLC9.7 mi · Dover, NH · Urgent care center

Pharmacies

BJS Wholesale Club Inc1.1 mi · Portsmouth, NH · Community/retail pharmacy
Maine Center for Cancer Medicine & Blood Disorders, P.A.1.1 mi · Portsmouth, NH · Community/retail pharmacy
Martin's Point Health Care, Inc1.1 mi · Portsmouth, NH · Pharmacy

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Portsmouth Regional Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	4 of 5 stars
Nurses communicated well	3 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	2 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	69%National average: 72%
Would definitely recommend the hospital	70%National average: 71%
Nurses “always” communicated well	77%National average: 80%
Doctors “always” communicated well	78%National average: 80%
Staff “always” explained medicines before giving them	59%National average: 62%
Were given information about recovery at home	85%National average: 86%
Room and bathroom “always” clean	73%National average: 74%
Area around the room “always” quiet at night	46%National average: 60%
Completed surveys	568Response rate: 26%

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	0.371No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.246Better than the national benchmark
Surgical site infections after colon surgery	1.052No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0Better than the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.294Better than the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	10.9%
Deaths within 30 days: heart failure patients	13.1%
Deaths within 30 days: pneumonia patients	14.6%
Deaths within 30 days: COPD patients	10.9%
Deaths within 30 days: stroke patients	12%
Deaths within 30 days: coronary bypass surgery (CABG)	2.4%
Serious complications (patient safety indicator PSI-90)	0.94No different from the national rate
Complications after hip or knee replacement	3.7%

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	15.4%
Readmitted within 30 days: heart failure	22.7%
Readmitted within 30 days: pneumonia	18.4%
Readmitted within 30 days: COPD	19.2%
Readmitted within 30 days: coronary bypass surgery	10.6%
Readmitted within 30 days: hip or knee replacement	5.9%

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	132 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	67%National average: 65%

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in New Hampshire

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 85 common services exactly as Portsmouth Regional Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 NP	$910	$910	$37.49 – $910
New patient office visit (about 30–44 minutes): 10 of 24 insurance plan rates Aetna — EPO: $576.03 Aetna — HMO: $576.03 Aetna — POS: $576.03 Aetna — PPO: $576.03 AmeriHealth Caritas — MCD: $37.49 Claritev (MultiPlan) — COMM: $737.10 CorVel — WorkersComp: $655.20 EverNorth — COMM: $728 First Health — PPO: $828.10 Healthcare Value Mgmt — COMM: $828.10
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 NP	$1,199	$1,199	$49.40 – $1,199
New patient office visit (about 45–59 minutes): 10 of 24 insurance plan rates Aetna — EPO: $758.97 Aetna — HMO: $758.97 Aetna — POS: $758.97 Aetna — PPO: $758.97 AmeriHealth Caritas — MCD: $49.40 Claritev (MultiPlan) — COMM: $971.19 CorVel — WorkersComp: $863.28 EverNorth — COMM: $959.20 First Health — PPO: $1,091.09 Healthcare Value Mgmt — COMM: $1,091.09
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 5 NP	$1,365	$1,365	$56.24 – $1,365
New patient office visit (about 60–74 minutes): 10 of 24 insurance plan rates Aetna — EPO: $864.04 Aetna — HMO: $864.04 Aetna — POS: $864.04 Aetna — PPO: $864.04 AmeriHealth Caritas — MCD: $56.24 Claritev (MultiPlan) — COMM: $1,105.65 CorVel — WorkersComp: $982.80 EverNorth — COMM: $1,092 First Health — PPO: $1,242.15 Healthcare Value Mgmt — COMM: $1,242.15
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 EST	$775	$775	$31.93 – $775
Established patient office visit (about 20–29 minutes): 10 of 24 insurance plan rates Aetna — EPO: $490.57 Aetna — HMO: $490.57 Aetna — POS: $490.57 Aetna — PPO: $490.57 AmeriHealth Caritas — MCD: $31.93 Claritev (MultiPlan) — COMM: $627.75 CorVel — WorkersComp: $558 EverNorth — COMM: $620 First Health — PPO: $705.25 Healthcare Value Mgmt — COMM: $705.25
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 EST	$1,578	$1,578	$65.01 – $1,578
Established patient office visit (about 30–39 minutes): 10 of 24 insurance plan rates Aetna — EPO: $998.87 Aetna — HMO: $998.87 Aetna — POS: $998.87 Aetna — PPO: $998.87 AmeriHealth Caritas — MCD: $65.01 Claritev (MultiPlan) — COMM: $1,278.18 CorVel — WorkersComp: $1,136.16 EverNorth — COMM: $1,262.40 First Health — PPO: $1,435.98 Healthcare Value Mgmt — COMM: $1,435.98
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin	Not listed in the file	Not listed in the file	$67.81 – $69.91
Preventive checkup, new patient, age 18–39: rates for 3 insurance plans Humana Military — TRICR: $67.81 Martin's Point Health — TRICR: $68.51 Sierra Military Health — TRICR: $69.91
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin	Not listed in the file	Not listed in the file	$82.40 – $84.95
Preventive checkup, new patient, age 40–64: rates for 3 insurance plans Humana Military — TRICR: $82.40 Martin's Point Health — TRICR: $83.25 Sierra Military Health — TRICR: $84.95
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: LVL 3 EMER DEPT	$3,374	$3,374	$139.01 – $3,205.30
Emergency room visit (moderate): 10 of 20 insurance plan rates AmeriHealth Caritas — MCD: $139.01 Anthem — INDEMNITY: $1,494.68 Anthem Maine — INDEMNITY: $1,494.68 Claritev (MultiPlan) — COMM: $2,732.94 CorVel — WorkersComp: $2,429.28 EverNorth — COMM: $2,699.20 First Health — PPO: $3,070.34 Healthcare Value Mgmt — COMM: $3,070.34 Maine Community Health — Individual: $1,055.05 Maine Community Health — LargeGroup: $1,787.88
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination	Not listed in the file	Not listed in the file	$791.52 – $2,524
Emergency room visit (moderate): 10 of 17 insurance plan rates Aetna — EPO: $791.52 Aetna — HMO: $791.52 Aetna — POS: $791.52 Aetna — PPO: $791.52 Anthem — BlueChoice: $2,075.40 Anthem — FEP: $2,873 Anthem — HMO: $2,306 Anthem — POS: $2,306 Anthem — PPO: $2,873 Anthem Maine — BlueChoice: $2,075.40
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · modifier ER In the file: LVL 3 FREE STD EMER DEPT	$3,374	$3,374	$139.01 – $3,205.30
Emergency room visit (moderate): 10 of 20 insurance plan rates AmeriHealth Caritas — MCD: $139.01 Anthem — INDEMNITY: $1,494.68 Anthem Maine — INDEMNITY: $1,494.68 Claritev (MultiPlan) — COMM: $2,732.94 CorVel — WorkersComp: $2,429.28 EverNorth — COMM: $2,699.20 First Health — PPO: $3,070.34 Healthcare Value Mgmt — COMM: $3,070.34 Maine Community Health — Individual: $1,055.05 Maine Community Health — LargeGroup: $1,787.88
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: LVL 4 EMER DEPT	$5,539	$5,539	$228.21 – $5,262.05
Emergency room visit (moderately high): 10 of 21 insurance plan rates AmeriHealth Caritas — MCD: $228.21 Anthem — INDEMNITY: $2,453.78 Anthem Maine — INDEMNITY: $2,453.78 Claritev (MultiPlan) — COMM: $4,486.59 CorVel — WorkersComp: $3,988.08 EverNorth — COMM: $4,431.20 First Health — PPO: $5,040.49 Healthcare Value Mgmt — COMM: $5,040.49 Maine Community Health — Individual: $1,732.05 Maine Community Health — LargeGroup: $2,935.12
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination	Not listed in the file	Not listed in the file	$4,246.20 – $6,115
Emergency room visit (moderately high): 10 of 16 insurance plan rates Aetna — EPO: $3,020.22 Aetna — HMO: $3,020.22 Aetna — POS: $3,020.22 Aetna — PPO: $3,020.22 Anthem — BlueChoice: $4,246.20 Anthem — FEP: $6,115 Anthem — HMO: $4,718 Anthem — POS: $4,718 Anthem — PPO: $6,115 Anthem Maine — BlueChoice: $4,246.20
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · modifier ER In the file: LVL 4 FREE STD EMER DEPT	$5,539	$5,539	$228.21 – $5,262.05
Emergency room visit (moderately high): 10 of 21 insurance plan rates AmeriHealth Caritas — MCD: $228.21 Anthem — INDEMNITY: $2,453.78 Anthem Maine — INDEMNITY: $2,453.78 Claritev (MultiPlan) — COMM: $4,486.59 CorVel — WorkersComp: $3,988.08 EverNorth — COMM: $4,431.20 First Health — PPO: $5,040.49 Healthcare Value Mgmt — COMM: $5,040.49 Maine Community Health — Individual: $1,732.05 Maine Community Health — LargeGroup: $2,935.12
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: LVL 5 EMER DEPT	$10,174	$10,174	$419.17 – $9,665.30
Emergency room visit (high): 10 of 20 insurance plan rates AmeriHealth Caritas — MCD: $419.17 Anthem — INDEMNITY: $4,507.08 Anthem Maine — INDEMNITY: $4,507.08 Claritev (MultiPlan) — COMM: $8,240.94 CorVel — WorkersComp: $7,325.28 EverNorth — COMM: $8,139.20 First Health — PPO: $9,258.34 Healthcare Value Mgmt — COMM: $9,258.34 Maine Community Health — Individual: $3,181.41 Maine Community Health — LargeGroup: $5,391.20
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination	Not listed in the file	Not listed in the file	$6,038.10 – $8,926
Emergency room visit (high): 10 of 17 insurance plan rates Aetna — EPO: $4,734.84 Aetna — HMO: $4,734.84 Aetna — POS: $4,734.84 Aetna — PPO: $4,734.84 Anthem — BlueChoice: $6,038.10 Anthem — FEP: $8,926 Anthem — HMO: $6,709 Anthem — POS: $6,709 Anthem — PPO: $8,926 Anthem Maine — BlueChoice: $6,038.10
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · modifier ER In the file: LVL 5 FREE STD EMER DEPT	$10,174	$10,174	$419.17 – $9,665.30
Emergency room visit (high): 10 of 20 insurance plan rates AmeriHealth Caritas — MCD: $419.17 Anthem — INDEMNITY: $4,507.08 Anthem Maine — INDEMNITY: $4,507.08 Claritev (MultiPlan) — COMM: $8,240.94 CorVel — WorkersComp: $7,325.28 EverNorth — COMM: $8,139.20 First Health — PPO: $9,258.34 Healthcare Value Mgmt — COMM: $9,258.34 Maine Community Health — Individual: $3,181.41 Maine Community Health — LargeGroup: $5,391.20

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BMP TOTAL CALCIUM	$615	$615	$158.06 – $584.25
Basic metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — EPO: $389.30 Aetna — HMO: $389.30 Aetna — POS: $389.30 Aetna — PPO: $389.30 Anthem — INDEMNITY: $272.44 Anthem Maine — INDEMNITY: $272.44 Claritev (MultiPlan) — COMM: $498.15 CorVel — WorkersComp: $442.80 EverNorth — COMM: $492 First Health — PPO: $559.65
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Ch	Not listed in the file	Not listed in the file	$14.59 – $34.09
Basic metabolic panel (blood test): 10 of 34 insurance plan rates Aetna — MCR: $8.46 AmeriHealth Caritas — MCD: $7.54 Anthem — BlueChoice: $14.59 Anthem — FEP: $34.09 Anthem — HMO: $16.21 Anthem — MCR: $8.63 Anthem — POS: $16.21 Anthem — PPO: $33.93 Anthem Maine — BlueChoice: $14.59 Anthem Maine — FEP: $34.09
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMP METABOLIC PANEL	$818	$818	$210.23 – $777.10
Comprehensive metabolic panel (blood test): 10 of 24 insurance plan rates Aetna — EPO: $517.79 Aetna — HMO: $517.79 Aetna — POS: $517.79 Aetna — PPO: $517.79 Anthem — INDEMNITY: $362.37 Anthem Maine — INDEMNITY: $362.37 Claritev (MultiPlan) — COMM: $662.58 CorVel — WorkersComp: $588.96 EverNorth — COMM: $654.40 First Health — PPO: $744.38
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon	Not listed in the file	Not listed in the file	$18.21 – $42.56
Comprehensive metabolic panel (blood test): 10 of 34 insurance plan rates Aetna — MCR: $10.56 AmeriHealth Caritas — MCD: $9.40 Anthem — BlueChoice: $18.21 Anthem — FEP: $42.56 Anthem — HMO: $20.23 Anthem — MCR: $10.77 Anthem — POS: $20.23 Anthem — PPO: $42.36 Anthem Maine — BlueChoice: $18.21 Anthem Maine — FEP: $42.56
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or	Not listed in the file	Not listed in the file	$82.44 – $192.67
Obstetric blood test panel: 10 of 34 insurance plan rates Aetna — MCR: $47.81 AmeriHealth Caritas — MCD: $42.60 Anthem — BlueChoice: $82.44 Anthem — FEP: $192.67 Anthem — HMO: $91.60 Anthem — MCR: $48.77 Anthem — POS: $91.60 Anthem — PPO: $191.77 Anthem Maine — BlueChoice: $82.44 Anthem Maine — FEP: $192.67
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL	$272	$272	$69.90 – $258.40
Cholesterol panel (lipid panel): 10 of 24 insurance plan rates Aetna — EPO: $172.18 Aetna — HMO: $172.18 Aetna — POS: $172.18 Aetna — PPO: $172.18 Anthem — INDEMNITY: $120.50 Anthem Maine — INDEMNITY: $120.50 Claritev (MultiPlan) — COMM: $220.32 CorVel — WorkersComp: $195.84 EverNorth — COMM: $217.60 First Health — PPO: $247.52
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester	Not listed in the file	Not listed in the file	$23.09 – $53.96
Cholesterol panel (lipid panel): 10 of 34 insurance plan rates Aetna — MCR: $13.39 AmeriHealth Caritas — MCD: $11.93 Anthem — BlueChoice: $23.09 Anthem — FEP: $53.96 Anthem — HMO: $25.66 Anthem — MCR: $13.66 Anthem — POS: $25.66 Anthem — PPO: $53.71 Anthem Maine — BlueChoice: $23.09 Anthem Maine — FEP: $53.96
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL	$179	$179	$46 – $170.05
Kidney function panel: 10 of 24 insurance plan rates Aetna — EPO: $113.31 Aetna — HMO: $113.31 Aetna — POS: $113.31 Aetna — PPO: $113.31 Anthem — INDEMNITY: $79.30 Anthem Maine — INDEMNITY: $79.30 Claritev (MultiPlan) — COMM: $144.99 CorVel — WorkersComp: $128.88 EverNorth — COMM: $143.20 First Health — PPO: $162.89
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chlo	Not listed in the file	Not listed in the file	$14.97 – $34.98
Kidney function panel: 10 of 34 insurance plan rates Aetna — MCR: $8.68 AmeriHealth Caritas — MCD: $7.74 Anthem — BlueChoice: $14.97 Anthem — FEP: $34.98 Anthem — HMO: $16.63 Anthem — MCR: $8.85 Anthem — POS: $16.63 Anthem — PPO: $34.82 Anthem Maine — BlueChoice: $14.97 Anthem Maine — FEP: $34.98
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL	$883	$883	$226.93 – $838.85
Liver function panel: 10 of 24 insurance plan rates Aetna — EPO: $558.94 Aetna — HMO: $558.94 Aetna — POS: $558.94 Aetna — PPO: $558.94 Anthem — INDEMNITY: $391.17 Anthem Maine — INDEMNITY: $391.17 Claritev (MultiPlan) — COMM: $715.23 CorVel — WorkersComp: $635.76 EverNorth — COMM: $706.40 First Health — PPO: $803.53
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase	Not listed in the file	Not listed in the file	$14.09 – $32.93
Liver function panel: 10 of 34 insurance plan rates Aetna — MCR: $8.17 AmeriHealth Caritas — MCD: $7.28 Anthem — BlueChoice: $14.09 Anthem — FEP: $32.93 Anthem — HMO: $15.65 Anthem — MCR: $8.33 Anthem — POS: $15.65 Anthem — PPO: $32.77 Anthem Maine — BlueChoice: $14.09 Anthem Maine — FEP: $32.93
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$234	$234	$2.82 – $16.68
Urine test (automated, with microscope): 10 of 34 insurance plan rates Aetna — MCR: $3.17 AmeriHealth Caritas — MCD: $2.82 Anthem — BlueChoice: $5.47 Anthem — FEP: $12.78 Anthem — HMO: $6.07 Anthem — MCR: $3.23 Anthem — POS: $6.07 Anthem — PPO: $12.71 Anthem Maine — BlueChoice: $5.47 Anthem Maine — FEP: $12.78
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA W MICRO AUTO	$234	$234	$60.14 – $222.30
Urine test (automated, with microscope): 10 of 24 insurance plan rates Aetna — EPO: $148.12 Aetna — HMO: $148.12 Aetna — POS: $148.12 Aetna — PPO: $148.12 Anthem — INDEMNITY: $103.66 Anthem Maine — INDEMNITY: $103.66 Claritev (MultiPlan) — COMM: $189.54 CorVel — WorkersComp: $168.48 EverNorth — COMM: $187.20 First Health — PPO: $212.94
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$52	$52	$3.10 – $18.30
Urine test (manual, without microscope): 10 of 34 insurance plan rates Aetna — MCR: $3.48 AmeriHealth Caritas — MCD: $3.10 Anthem — BlueChoice: $6 Anthem — FEP: $14.02 Anthem — HMO: $6.67 Anthem — MCR: $3.55 Anthem — POS: $6.67 Anthem — PPO: $13.96 Anthem Maine — BlueChoice: $6 Anthem Maine — FEP: $14.02
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: PROTEIN UR QUAL MAN	$52	$52	$13.36 – $49.40
Urine test (manual, without microscope): 10 of 24 insurance plan rates Aetna — EPO: $32.92 Aetna — HMO: $32.92 Aetna — POS: $32.92 Aetna — PPO: $32.92 Anthem — INDEMNITY: $23.04 Anthem Maine — INDEMNITY: $23.04 Claritev (MultiPlan) — COMM: $42.12 CorVel — WorkersComp: $37.44 EverNorth — COMM: $41.60 First Health — PPO: $47.32
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA W O MICRO AUTO	$187	$187	$48.06 – $177.65
Urine test (automated, without microscope): 10 of 24 insurance plan rates Aetna — EPO: $118.37 Aetna — HMO: $118.37 Aetna — POS: $118.37 Aetna — PPO: $118.37 Anthem — INDEMNITY: $82.84 Anthem Maine — INDEMNITY: $82.84 Claritev (MultiPlan) — COMM: $151.47 CorVel — WorkersComp: $134.64 EverNorth — COMM: $149.60 First Health — PPO: $170.17
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	Not listed in the file	Not listed in the file	$2.01 – $11.92
Urine test (automated, without microscope): 10 of 34 insurance plan rates Aetna — MCR: $2.25 AmeriHealth Caritas — MCD: $2.01 Anthem — BlueChoice: $3.88 Anthem — FEP: $9.07 Anthem — HMO: $4.31 Anthem — MCR: $2.29 Anthem — POS: $4.31 Anthem — PPO: $9.02 Anthem Maine — BlueChoice: $3.88 Anthem Maine — FEP: $9.07
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PROS SPEC AG (PSA) TOTAL	$659	$659	$169.36 – $626.05
PSA (prostate specific antigen) blood test: 10 of 24 insurance plan rates Aetna — EPO: $417.15 Aetna — HMO: $417.15 Aetna — POS: $417.15 Aetna — PPO: $417.15 Anthem — INDEMNITY: $291.94 Anthem Maine — INDEMNITY: $291.94 Claritev (MultiPlan) — COMM: $533.79 CorVel — WorkersComp: $474.48 EverNorth — COMM: $527.20 First Health — PPO: $599.69
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total	Not listed in the file	Not listed in the file	$31.71 – $74.11
PSA (prostate specific antigen) blood test: 10 of 34 insurance plan rates Aetna — MCR: $18.39 AmeriHealth Caritas — MCD: $16.39 Anthem — BlueChoice: $31.71 Anthem — FEP: $74.11 Anthem — HMO: $35.24 Anthem — MCR: $18.76 Anthem — POS: $35.24 Anthem — PPO: $73.76 Anthem Maine — BlueChoice: $31.71 Anthem Maine — FEP: $74.11
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH	$339	$339	$87.12 – $322.05
Thyroid stimulating hormone (TSH) test: 10 of 24 insurance plan rates Aetna — EPO: $214.59 Aetna — HMO: $214.59 Aetna — POS: $214.59 Aetna — PPO: $214.59 Anthem — INDEMNITY: $150.18 Anthem Maine — INDEMNITY: $150.18 Claritev (MultiPlan) — COMM: $274.59 CorVel — WorkersComp: $244.08 EverNorth — COMM: $271.20 First Health — PPO: $308.49
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH)	Not listed in the file	Not listed in the file	$28.97 – $67.70
Thyroid stimulating hormone (TSH) test: 10 of 34 insurance plan rates Aetna — MCR: $16.80 AmeriHealth Caritas — MCD: $14.97 Anthem — BlueChoice: $28.97 Anthem — FEP: $67.70 Anthem — HMO: $32.19 Anthem — MCR: $17.14 Anthem — POS: $32.19 Anthem — PPO: $67.38 Anthem Maine — BlueChoice: $28.97 Anthem Maine — FEP: $67.70
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count	Not listed in the file	Not listed in the file	$13.40 – $31.31
Complete blood count (CBC) with differential: 10 of 34 insurance plan rates Aetna — MCR: $7.77 AmeriHealth Caritas — MCD: $6.92 Anthem — BlueChoice: $13.40 Anthem — FEP: $31.31 Anthem — HMO: $14.89 Anthem — MCR: $7.93 Anthem — POS: $14.89 Anthem — PPO: $31.17 Anthem Maine — BlueChoice: $13.40 Anthem Maine — FEP: $31.31
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC AUTOMATED	$137	$137	$35.21 – $130.15
Complete blood count (CBC), automated: 10 of 24 insurance plan rates Aetna — EPO: $86.72 Aetna — HMO: $86.72 Aetna — POS: $86.72 Aetna — PPO: $86.72 Anthem — INDEMNITY: $60.69 Anthem Maine — INDEMNITY: $60.69 Claritev (MultiPlan) — COMM: $110.97 CorVel — WorkersComp: $98.64 EverNorth — COMM: $109.60 First Health — PPO: $124.67
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)	Not listed in the file	Not listed in the file	$11.16 – $26.07
Complete blood count (CBC), automated: 10 of 34 insurance plan rates Aetna — MCR: $6.47 AmeriHealth Caritas — MCD: $5.77 Anthem — BlueChoice: $11.16 Anthem — FEP: $26.07 Anthem — HMO: $12.40 Anthem — MCR: $6.60 Anthem — POS: $12.40 Anthem — PPO: $25.95 Anthem Maine — BlueChoice: $11.16 Anthem Maine — FEP: $26.07
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTIME	$85	$85	$21.84 – $80.75
Blood clotting time test (prothrombin time, PT): 10 of 24 insurance plan rates Aetna — EPO: $53.80 Aetna — HMO: $53.80 Aetna — POS: $53.80 Aetna — PPO: $53.80 Anthem — INDEMNITY: $37.65 Anthem Maine — INDEMNITY: $37.65 Claritev (MultiPlan) — COMM: $68.85 CorVel — WorkersComp: $61.20 EverNorth — COMM: $68 First Health — PPO: $77.35
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time;	Not listed in the file	Not listed in the file	$7.40 – $17.29
Blood clotting time test (prothrombin time, PT): 10 of 34 insurance plan rates Aetna — MCR: $4.29 AmeriHealth Caritas — MCD: $3.82 Anthem — BlueChoice: $7.40 Anthem — FEP: $17.29 Anthem — HMO: $8.22 Anthem — MCR: $4.38 Anthem — POS: $8.22 Anthem — PPO: $17.21 Anthem Maine — BlueChoice: $7.40 Anthem Maine — FEP: $17.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT	$123	$123	$31.61 – $116.85
Blood clotting test (partial thromboplastin time, PTT): 10 of 24 insurance plan rates Aetna — EPO: $77.86 Aetna — HMO: $77.86 Aetna — POS: $77.86 Aetna — PPO: $77.86 Anthem — INDEMNITY: $54.49 Anthem Maine — INDEMNITY: $54.49 Claritev (MultiPlan) — COMM: $99.63 CorVel — WorkersComp: $88.56 EverNorth — COMM: $98.40 First Health — PPO: $111.93
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time, partial (PTT); plasma or whole blood	Not listed in the file	Not listed in the file	$10.36 – $24.22
Blood clotting test (partial thromboplastin time, PTT): 10 of 34 insurance plan rates Aetna — MCR: $6.01 AmeriHealth Caritas — MCD: $5.36 Anthem — BlueChoice: $10.36 Anthem — FEP: $24.22 Anthem — HMO: $11.52 Anthem — MCR: $6.13 Anthem — POS: $11.52 Anthem — PPO: $24.11 Anthem Maine — BlueChoice: $10.36 Anthem Maine — FEP: $24.22

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD/BRAIN W/O CONT	$5,864	$5,864	$241.60 – $5,570.80
CT scan of the head or brain, without contrast: 10 of 22 insurance plan rates Aetna — EPO: $3,711.91 Aetna — HMO: $3,711.91 Aetna — POS: $3,711.91 Aetna — PPO: $3,711.91 AmeriHealth Caritas — MCD: $241.60 Claritev (MultiPlan) — COMM: $4,749.84 CorVel — WorkersComp: $4,222.08 EverNorth — COMM: $4,691.20 First Health — PPO: $5,336.24 Healthcare Value Mgmt — COMM: $5,336.24
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: Computed tomography, head or brain; without contrast material	$5,864	$5,864	$476.97 – $529.96
CT scan of the head or brain, without contrast: 10 of 15 insurance plan rates Anthem — BlueChoice: $476.97 Anthem — FEP: $529.96 Anthem — HMO: $529.96 Anthem — POS: $529.96 Anthem — PPO: $529.96 Anthem Maine — BlueChoice: $476.97 Anthem Maine — FEP: $529.96 Anthem Maine — HMO: $529.96 Anthem Maine — POS: $529.96 Anthem Maine — PPO: $529.96
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · modifier TC In the file: Computed tomography, head or brain; without contrast material	Not listed in the file	Not listed in the file	$305.56 – $339.51
CT scan of the head or brain, without contrast: rates for 10 insurance plans Anthem — BlueChoice: $305.56 Anthem — FEP: $339.51 Anthem — HMO: $339.51 Anthem — POS: $339.51 Anthem — PPO: $339.51 Anthem Maine — BlueChoice: $305.56 Anthem Maine — FEP: $339.51 Anthem Maine — HMO: $339.51 Anthem Maine — POS: $339.51 Anthem Maine — PPO: $339.51
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN W&WO CONT	$9,146	$9,146	$376.82 – $8,688.70
MRI of the brain, before and after contrast: 10 of 22 insurance plan rates Aetna — EPO: $5,789.42 Aetna — HMO: $5,789.42 Aetna — POS: $5,789.42 Aetna — PPO: $5,789.42 AmeriHealth Caritas — MCD: $376.82 Claritev (MultiPlan) — COMM: $7,408.26 CorVel — WorkersComp: $6,585.12 EverNorth — COMM: $7,316.80 First Health — PPO: $8,322.86 Healthcare Value Mgmt — COMM: $8,322.86
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth	$9,146	$9,146	$1,327.93 – $1,659.94
MRI of the brain, before and after contrast: 10 of 17 insurance plan rates Anthem — BlueChoice: $1,421.48 Anthem — FEP: $1,579.42 Anthem — HMO: $1,579.42 Anthem — POS: $1,579.42 Anthem — PPO: $1,579.42 Anthem Maine — BlueChoice: $1,421.48 Anthem Maine — FEP: $1,579.42 Anthem Maine — HMO: $1,579.42 Anthem Maine — POS: $1,579.42 Anthem Maine — PPO: $1,579.42
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · modifier TC In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth	Not listed in the file	Not listed in the file	$963.83 – $1,070.92
MRI of the brain, before and after contrast: rates for 10 insurance plans Anthem — BlueChoice: $963.83 Anthem — FEP: $1,070.92 Anthem — HMO: $1,070.92 Anthem — POS: $1,070.92 Anthem — PPO: $1,070.92 Anthem Maine — BlueChoice: $963.83 Anthem Maine — FEP: $1,070.92 Anthem Maine — HMO: $1,070.92 Anthem Maine — POS: $1,070.92 Anthem Maine — PPO: $1,070.92
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CHEST XRAY 2 V	$335	$335	$13.80 – $318.25
Chest X-ray, 2 views: 10 of 23 insurance plan rates Aetna — EPO: $212.06 Aetna — HMO: $212.06 Aetna — POS: $212.06 Aetna — PPO: $212.06 AmeriHealth Caritas — MCD: $13.80 Claritev (MultiPlan) — COMM: $271.35 CorVel — WorkersComp: $241.20 EverNorth — COMM: $268 First Health — PPO: $304.85 Healthcare Value Mgmt — COMM: $304.85
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: Radiologic examination, chest; 2 views	$335	$335	$148.32 – $726.73
Chest X-ray, 2 views: 10 of 17 insurance plan rates Anthem — BlueChoice: $148.32 Anthem — FEP: $164.80 Anthem — HMO: $164.80 Anthem — POS: $164.80 Anthem — PPO: $164.80 Anthem Maine — BlueChoice: $148.32 Anthem Maine — FEP: $164.80 Anthem Maine — HMO: $164.80 Anthem Maine — POS: $164.80 Anthem Maine — PPO: $164.80
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier TC In the file: Radiologic examination, chest; 2 views	$335	$335	$104.64 – $116.26
Chest X-ray, 2 views: rates for 10 insurance plans Anthem — BlueChoice: $104.64 Anthem — FEP: $116.26 Anthem — HMO: $116.26 Anthem — POS: $116.26 Anthem — PPO: $116.26 Anthem Maine — BlueChoice: $104.64 Anthem Maine — FEP: $116.26 Anthem Maine — HMO: $116.26 Anthem Maine — POS: $116.26 Anthem Maine — PPO: $116.26
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR L-SPINE 4 + VIEWS	$595	$595	$24.51 – $565.25
X-ray of the lower spine, at least 4 views: 10 of 23 insurance plan rates Aetna — EPO: $376.63 Aetna — HMO: $376.63 Aetna — POS: $376.63 Aetna — PPO: $376.63 AmeriHealth Caritas — MCD: $24.51 Claritev (MultiPlan) — COMM: $481.95 CorVel — WorkersComp: $428.40 EverNorth — COMM: $476 First Health — PPO: $541.45 Healthcare Value Mgmt — COMM: $541.45
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views	$595	$595	$894.01
X-ray of the lower spine, at least 4 views: 10 of 17 insurance plan rates Anthem — BlueChoice: $240.45 Anthem — FEP: $267.17 Anthem — HMO: $267.17 Anthem — POS: $267.17 Anthem — PPO: $267.17 Anthem Maine — BlueChoice: $240.45 Anthem Maine — FEP: $267.17 Anthem Maine — HMO: $267.17 Anthem Maine — POS: $267.17 Anthem Maine — PPO: $267.17
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier 26 In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views	$595	$595	$55.17 – $61.30
X-ray of the lower spine, at least 4 views: rates for 10 insurance plans Anthem — BlueChoice: $55.17 Anthem — FEP: $61.30 Anthem — HMO: $61.30 Anthem — POS: $61.30 Anthem — PPO: $61.30 Anthem Maine — BlueChoice: $55.17 Anthem Maine — FEP: $61.30 Anthem Maine — HMO: $61.30 Anthem Maine — POS: $61.30 Anthem Maine — PPO: $61.30
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI L-SPINE W/O CONT	$7,613	$7,613	$313.66 – $7,232.35
MRI of the lower back (lumbar spine), without contrast: 10 of 22 insurance plan rates Aetna — EPO: $4,819.03 Aetna — HMO: $4,819.03 Aetna — POS: $4,819.03 Aetna — PPO: $4,819.03 AmeriHealth Caritas — MCD: $313.66 Claritev (MultiPlan) — COMM: $6,166.53 CorVel — WorkersComp: $5,481.36 EverNorth — COMM: $6,090.40 First Health — PPO: $6,927.83 Healthcare Value Mgmt — COMM: $6,927.83
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material	$7,613	$7,613	$2,754 – $3,591
MRI of the lower back (lumbar spine), without contrast: 10 of 17 insurance plan rates Anthem — BlueChoice: $858.98 Anthem — FEP: $954.42 Anthem — HMO: $954.42 Anthem — POS: $954.42 Anthem — PPO: $954.42 Anthem Maine — BlueChoice: $858.98 Anthem Maine — FEP: $954.42 Anthem Maine — HMO: $954.42 Anthem Maine — POS: $954.42 Anthem Maine — PPO: $954.42
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · modifier 26 In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material	Not listed in the file	Not listed in the file	$298.10 – $331.23
MRI of the lower back (lumbar spine), without contrast: rates for 10 insurance plans Anthem — BlueChoice: $298.10 Anthem — FEP: $331.23 Anthem — HMO: $331.23 Anthem — POS: $331.23 Anthem — PPO: $331.23 Anthem Maine — BlueChoice: $298.10 Anthem Maine — FEP: $331.23 Anthem Maine — HMO: $331.23 Anthem Maine — POS: $331.23 Anthem Maine — PPO: $331.23
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/CONTRAST	$9,726	$9,726	$400.71 – $9,239.70
CT scan of the pelvis, with contrast: 10 of 22 insurance plan rates Aetna — EPO: $6,156.56 Aetna — HMO: $6,156.56 Aetna — POS: $6,156.56 Aetna — PPO: $6,156.56 AmeriHealth Caritas — MCD: $400.71 Claritev (MultiPlan) — COMM: $7,878.06 CorVel — WorkersComp: $7,002.72 EverNorth — COMM: $7,780.80 First Health — PPO: $8,850.66 Healthcare Value Mgmt — COMM: $8,850.66
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Computed tomography, pelvis; with contrast material(s)	$9,726	$9,726	$1,016.94 – $1,129.93
CT scan of the pelvis, with contrast: 10 of 15 insurance plan rates Anthem — BlueChoice: $1,016.94 Anthem — FEP: $1,129.93 Anthem — HMO: $1,129.93 Anthem — POS: $1,129.93 Anthem — PPO: $1,129.93 Anthem Maine — BlueChoice: $1,016.94 Anthem Maine — FEP: $1,129.93 Anthem Maine — HMO: $1,129.93 Anthem Maine — POS: $1,129.93 Anthem Maine — PPO: $1,129.93
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · modifier 26 In the file: Computed tomography, pelvis; with contrast material(s)	Not listed in the file	Not listed in the file	$232.32 – $258.13
CT scan of the pelvis, with contrast: rates for 10 insurance plans Anthem — BlueChoice: $232.32 Anthem — FEP: $258.13 Anthem — HMO: $258.13 Anthem — POS: $258.13 Anthem — PPO: $258.13 Anthem Maine — BlueChoice: $232.32 Anthem Maine — FEP: $258.13 Anthem Maine — HMO: $258.13 Anthem Maine — POS: $258.13 Anthem Maine — PPO: $258.13
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material	Not listed in the file	Not listed in the file	$2,754 – $3,591
MRI of a leg joint (such as the knee), without contrast: 10 of 17 insurance plan rates Anthem — BlueChoice: $918.08 Anthem — FEP: $1,020.09 Anthem — HMO: $1,020.09 Anthem — POS: $1,020.09 Anthem — PPO: $1,020.09 Anthem Maine — BlueChoice: $918.08 Anthem Maine — FEP: $1,020.09 Anthem Maine — HMO: $1,020.09 Anthem Maine — POS: $1,020.09 Anthem Maine — PPO: $1,020.09
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier LT In the file: MRI LW JNT W/O CONT LT	$6,891	$6,891	$283.91 – $6,546.45
MRI of a leg joint (such as the knee), without contrast: 10 of 22 insurance plan rates Aetna — EPO: $4,362 Aetna — HMO: $4,362 Aetna — POS: $4,362 Aetna — PPO: $4,362 AmeriHealth Caritas — MCD: $283.91 Claritev (MultiPlan) — COMM: $5,581.71 CorVel — WorkersComp: $4,961.52 EverNorth — COMM: $5,512.80 First Health — PPO: $6,270.81 Healthcare Value Mgmt — COMM: $6,270.81
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier RT In the file: MRI LW JNT W/O CONT RT	$6,891	$6,891	$283.91 – $6,546.45
MRI of a leg joint (such as the knee), without contrast: 10 of 22 insurance plan rates Aetna — EPO: $4,362 Aetna — HMO: $4,362 Aetna — POS: $4,362 Aetna — PPO: $4,362 AmeriHealth Caritas — MCD: $283.91 Claritev (MultiPlan) — COMM: $5,581.71 CorVel — WorkersComp: $4,961.52 EverNorth — COMM: $5,512.80 First Health — PPO: $6,270.81 Healthcare Value Mgmt — COMM: $6,270.81
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD&PELVIS W/CONT	$13,697	$13,697	$564.32 – $13,012.15
CT scan of the abdomen and pelvis, with contrast: 10 of 22 insurance plan rates Aetna — EPO: $8,670.20 Aetna — HMO: $8,670.20 Aetna — POS: $8,670.20 Aetna — PPO: $8,670.20 AmeriHealth Caritas — MCD: $564.32 Claritev (MultiPlan) — COMM: $11,094.57 CorVel — WorkersComp: $9,861.84 EverNorth — COMM: $10,957.60 First Health — PPO: $12,464.27 Healthcare Value Mgmt — COMM: $12,464.27
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: Computed tomography, abdomen and pelvis; with contrast material(s)	$13,697	$13,697	$1,349.99 – $1,499.99
CT scan of the abdomen and pelvis, with contrast: 10 of 15 insurance plan rates Anthem — BlueChoice: $1,349.99 Anthem — FEP: $1,499.99 Anthem — HMO: $1,499.99 Anthem — POS: $1,499.99 Anthem — PPO: $1,499.99 Anthem Maine — BlueChoice: $1,349.99 Anthem Maine — FEP: $1,499.99 Anthem Maine — HMO: $1,499.99 Anthem Maine — POS: $1,499.99 Anthem Maine — PPO: $1,499.99
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · modifier TC In the file: Computed tomography, abdomen and pelvis; with contrast material(s)	Not listed in the file	Not listed in the file	$985.54 – $1,095.05
CT scan of the abdomen and pelvis, with contrast: rates for 10 insurance plans Anthem — BlueChoice: $985.54 Anthem — FEP: $1,095.05 Anthem — HMO: $1,095.05 Anthem — POS: $1,095.05 Anthem — PPO: $1,095.05 Anthem Maine — BlueChoice: $985.54 Anthem Maine — FEP: $1,095.05 Anthem Maine — HMO: $1,095.05 Anthem Maine — POS: $1,095.05 Anthem Maine — PPO: $1,095.05
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE	$2,445	$2,445	$100.73 – $2,322.75
Ultrasound of the abdomen, complete: 10 of 23 insurance plan rates Aetna — EPO: $1,547.68 Aetna — HMO: $1,547.68 Aetna — POS: $1,547.68 Aetna — PPO: $1,547.68 AmeriHealth Caritas — MCD: $100.73 Claritev (MultiPlan) — COMM: $1,980.45 CorVel — WorkersComp: $1,760.40 EverNorth — COMM: $1,956 First Health — PPO: $2,224.95 Healthcare Value Mgmt — COMM: $2,224.95
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: Ultrasound, abdominal, real time with image documentation; complete	$2,445	$2,445	$894.01
Ultrasound of the abdomen, complete: 10 of 17 insurance plan rates Anthem — BlueChoice: $512.26 Anthem — FEP: $569.18 Anthem — HMO: $569.18 Anthem — POS: $569.18 Anthem — PPO: $569.18 Anthem Maine — BlueChoice: $512.26 Anthem Maine — FEP: $569.18 Anthem Maine — HMO: $569.18 Anthem Maine — POS: $569.18 Anthem Maine — PPO: $569.18
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · modifier 26 In the file: Ultrasound, abdominal, real time with image documentation; complete	$2,445	$2,445	$162.97 – $181.08
Ultrasound of the abdomen, complete: rates for 10 insurance plans Anthem — BlueChoice: $162.97 Anthem — FEP: $181.08 Anthem — HMO: $181.08 Anthem — POS: $181.08 Anthem — PPO: $181.08 Anthem Maine — BlueChoice: $162.97 Anthem Maine — FEP: $181.08 Anthem Maine — HMO: $181.08 Anthem Maine — POS: $181.08 Anthem Maine — PPO: $181.08
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US PREG AFTER 1ST TRI	$1,679	$1,679	$69.17 – $1,595.05
Pregnancy ultrasound (after the first trimester): 10 of 23 insurance plan rates Aetna — EPO: $1,062.81 Aetna — HMO: $1,062.81 Aetna — POS: $1,062.81 Aetna — PPO: $1,062.81 AmeriHealth Caritas — MCD: $69.17 Claritev (MultiPlan) — COMM: $1,359.99 CorVel — WorkersComp: $1,208.88 EverNorth — COMM: $1,343.20 First Health — PPO: $1,527.89 Healthcare Value Mgmt — COMM: $1,527.89
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day	$1,679	$1,679	$894.01
Pregnancy ultrasound (after the first trimester): 10 of 17 insurance plan rates Anthem — BlueChoice: $609.49 Anthem — FEP: $677.21 Anthem — HMO: $677.21 Anthem — POS: $677.21 Anthem — PPO: $677.21 Anthem Maine — BlueChoice: $609.49 Anthem Maine — FEP: $677.21 Anthem Maine — HMO: $677.21 Anthem Maine — POS: $677.21 Anthem Maine — PPO: $677.21
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier 26 In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day	$1,679	$1,679	$205.37 – $228.19
Pregnancy ultrasound (after the first trimester): rates for 10 insurance plans Anthem — BlueChoice: $205.37 Anthem — FEP: $228.19 Anthem — HMO: $228.19 Anthem — POS: $228.19 Anthem — PPO: $228.19 Anthem Maine — BlueChoice: $205.37 Anthem Maine — FEP: $228.19 Anthem Maine — HMO: $228.19 Anthem Maine — POS: $228.19 Anthem Maine — PPO: $228.19
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRANSVAGINAL	$1,983	$1,983	$81.70 – $1,883.85
Transvaginal ultrasound: 10 of 23 insurance plan rates Aetna — EPO: $1,255.24 Aetna — HMO: $1,255.24 Aetna — POS: $1,255.24 Aetna — PPO: $1,255.24 AmeriHealth Caritas — MCD: $81.70 Claritev (MultiPlan) — COMM: $1,606.23 CorVel — WorkersComp: $1,427.76 EverNorth — COMM: $1,586.40 First Health — PPO: $1,804.53 Healthcare Value Mgmt — COMM: $1,804.53
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Ultrasound, transvaginal	$1,983	$1,983	$894.01
Transvaginal ultrasound: 10 of 17 insurance plan rates Anthem — BlueChoice: $528.36 Anthem — FEP: $587.07 Anthem — HMO: $587.07 Anthem — POS: $587.07 Anthem — PPO: $587.07 Anthem Maine — BlueChoice: $528.36 Anthem Maine — FEP: $587.07 Anthem Maine — HMO: $587.07 Anthem Maine — POS: $587.07 Anthem Maine — PPO: $587.07
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier 26 In the file: Ultrasound, transvaginal	$1,983	$1,983	$141.04 – $156.71
Transvaginal ultrasound: rates for 10 insurance plans Anthem — BlueChoice: $141.04 Anthem — FEP: $156.71 Anthem — HMO: $156.71 Anthem — POS: $156.71 Anthem — PPO: $156.71 Anthem Maine — BlueChoice: $141.04 Anthem Maine — FEP: $156.71 Anthem Maine — HMO: $156.71 Anthem Maine — POS: $156.71 Anthem Maine — PPO: $156.71
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral	Not listed in the file	Not listed in the file	$86.97 – $404.62
Diagnostic mammogram, one breast: 10 of 33 insurance plan rates Aetna — MCR: $89.65 Anthem — BlueChoice: $556.42 Anthem — FEP: $618.24 Anthem — HMO: $618.24 Anthem — MCR: $91.44 Anthem — POS: $618.24 Anthem — PPO: $618.24 Anthem Maine — BlueChoice: $556.42 Anthem Maine — FEP: $618.24 Anthem Maine — HMO: $618.24
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier RT In the file: MAMMO DIAG CAD UNI RT	$975	$975	$40.17 – $926.25
Diagnostic mammogram, one breast: 10 of 23 insurance plan rates Aetna — EPO: $617.17 Aetna — HMO: $617.17 Aetna — POS: $617.17 Aetna — PPO: $617.17 AmeriHealth Caritas — MCD: $40.17 Claritev (MultiPlan) — COMM: $789.75 CorVel — WorkersComp: $702 EverNorth — COMM: $780 First Health — PPO: $887.25 Healthcare Value Mgmt — COMM: $887.25
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier LT In the file: MAMMO DIAG CAD UNI LT	$975	$975	$40.17 – $926.25
Diagnostic mammogram, one breast: 10 of 23 insurance plan rates Aetna — EPO: $617.17 Aetna — HMO: $617.17 Aetna — POS: $617.17 Aetna — PPO: $617.17 AmeriHealth Caritas — MCD: $40.17 Claritev (MultiPlan) — COMM: $789.75 CorVel — WorkersComp: $702 EverNorth — COMM: $780 First Health — PPO: $887.25 Healthcare Value Mgmt — COMM: $887.25
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAMMO DIAG CAD BI	$1,153	$1,153	$47.50 – $1,095.35
Diagnostic mammogram, both breasts: 10 of 23 insurance plan rates Aetna — EPO: $729.85 Aetna — HMO: $729.85 Aetna — POS: $729.85 Aetna — PPO: $729.85 AmeriHealth Caritas — MCD: $47.50 Claritev (MultiPlan) — COMM: $933.93 CorVel — WorkersComp: $830.16 EverNorth — COMM: $922.40 First Health — PPO: $1,049.23 Healthcare Value Mgmt — COMM: $1,049.23
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral	Not listed in the file	Not listed in the file	$704.87 – $949.40
Diagnostic mammogram, both breasts: 10 of 33 insurance plan rates Aetna — MCR: $114.98 Anthem — BlueChoice: $704.87 Anthem — FEP: $783.19 Anthem — HMO: $783.19 Anthem — MCR: $117.28 Anthem — POS: $783.19 Anthem — PPO: $783.19 Anthem Maine — BlueChoice: $704.87 Anthem Maine — FEP: $783.19 Anthem Maine — HMO: $783.19
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier TC In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral	Not listed in the file	Not listed in the file	$503.01 – $558.90
Diagnostic mammogram, both breasts: rates for 10 insurance plans Anthem — BlueChoice: $503.01 Anthem — FEP: $558.90 Anthem — HMO: $558.90 Anthem — POS: $558.90 Anthem — PPO: $558.90 Anthem Maine — BlueChoice: $503.01 Anthem Maine — FEP: $558.90 Anthem Maine — HMO: $558.90 Anthem Maine — POS: $558.90 Anthem Maine — PPO: $558.90
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO SCR CAD BI	$950	$950	$39.14 – $902.50
Screening mammogram, both breasts: 10 of 23 insurance plan rates Aetna — EPO: $601.35 Aetna — HMO: $601.35 Aetna — POS: $601.35 Aetna — PPO: $601.35 AmeriHealth Caritas — MCD: $39.14 Claritev (MultiPlan) — COMM: $769.50 CorVel — WorkersComp: $684 EverNorth — COMM: $760 First Health — PPO: $864.50 Healthcare Value Mgmt — COMM: $864.50
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed	Not listed in the file	Not listed in the file	$567.85 – $787.32
Screening mammogram, both breasts: 10 of 33 insurance plan rates Aetna — MCR: $94.87 Anthem — BlueChoice: $567.85 Anthem — FEP: $630.95 Anthem — HMO: $630.95 Anthem — MCR: $96.77 Anthem — POS: $630.95 Anthem — PPO: $630.95 Anthem Maine — BlueChoice: $567.85 Anthem Maine — FEP: $630.95 Anthem Maine — HMO: $630.95
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier FY In the file: CR MAMMO SCR CAD BI	$950	$950	$39.14 – $902.50
Screening mammogram, both breasts: 10 of 23 insurance plan rates Aetna — EPO: $601.35 Aetna — HMO: $601.35 Aetna — POS: $601.35 Aetna — PPO: $601.35 AmeriHealth Caritas — MCD: $39.14 Claritev (MultiPlan) — COMM: $769.50 CorVel — WorkersComp: $684 EverNorth — COMM: $760 First Health — PPO: $864.50 Healthcare Value Mgmt — COMM: $864.50

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report	Not listed in the file	Not listed in the file	$12.90 – $13.30
Electrocardiogram (ECG/EKG) with reading: rates for 3 insurance plans Humana Military — TRICR: $12.90 Martin's Point Health — TRICR: $13.03 Sierra Military Health — TRICR: $13.30
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when pe	Not listed in the file	Not listed in the file	$9,744.30 – $14,408
Left heart catheterization (diagnostic): 10 of 12 insurance plan rates Anthem — BlueChoice: $9,744.30 Anthem — FEP: $14,408 Anthem — HMO: $10,827 Anthem — POS: $10,827 Anthem — PPO: $14,408 Anthem Maine — BlueChoice: $9,744.30 Anthem Maine — FEP: $14,408 Anthem Maine — HMO: $10,827 Anthem Maine — POS: $10,827 Anthem Maine — PPO: $14,408
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: EP W/O ARRHYTHMIA	$24,420	$24,420	$1,006.10 – $23,199
Heart rhythm study (electrophysiology evaluation): 10 of 24 insurance plan rates Aetna — EPO: $15,457.86 Aetna — HMO: $15,457.86 Aetna — POS: $15,457.86 Aetna — PPO: $15,457.86 AmeriHealth Caritas — MCD: $1,006.10 Anthem — INDEMNITY: $10,818.06 Anthem Maine — INDEMNITY: $10,818.06 Claritev (MultiPlan) — COMM: $19,780.20 CorVel — WorkersComp: $17,582.40 EverNorth — COMM: $19,536
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recor	$24,420	$24,420	$34,805.70 – $51,469
Heart rhythm study (electrophysiology evaluation): rates for 10 insurance plans Anthem — BlueChoice: $34,805.70 Anthem — FEP: $51,469 Anthem — HMO: $38,673 Anthem — POS: $38,673 Anthem — PPO: $51,469 Anthem Maine — BlueChoice: $34,805.70 Anthem Maine — FEP: $51,469 Anthem Maine — HMO: $38,673 Anthem Maine — POS: $38,673 Anthem Maine — PPO: $51,469
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: COM EP REPO CTH TX AFIB	$80,184	$80,184	$3,303.58 – $76,174.80
Heart rhythm study with ablation for atrial fibrillation: 10 of 24 insurance plan rates Aetna — EPO: $50,756.47 Aetna — HMO: $50,756.47 Aetna — POS: $50,756.47 Aetna — PPO: $50,756.47 AmeriHealth Caritas — MCD: $3,303.58 Anthem — INDEMNITY: $35,521.51 Anthem Maine — INDEMNITY: $35,521.51 Claritev (MultiPlan) — COMM: $64,949.04 CorVel — WorkersComp: $57,732.48 EverNorth — COMM: $64,147.20
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters,	$80,184	$80,184	$34,805.70 – $51,469
Heart rhythm study with ablation for atrial fibrillation: rates for 10 insurance plans Anthem — BlueChoice: $34,805.70 Anthem — FEP: $51,469 Anthem — HMO: $38,673 Anthem — POS: $38,673 Anthem — PPO: $51,469 Anthem Maine — BlueChoice: $34,805.70 Anthem Maine — FEP: $51,469 Anthem Maine — HMO: $38,673 Anthem Maine — POS: $38,673 Anthem Maine — PPO: $51,469
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: POLYSOMNOGRAPHY >4 PAR	$9,886	$9,886	$407.30 – $9,391.70
Sleep study (overnight, in a sleep lab): 10 of 32 insurance plan rates Aetna — EPO: $6,257.84 Aetna — HMO: $6,257.84 Aetna — POS: $6,257.84 Aetna — PPO: $6,257.84 AmeriHealth Caritas — MCD: $407.30 Anthem — INDEMNITY: $4,379.50 Anthem Maine — INDEMNITY: $4,379.50 Cigna — HMO: $3,598.50 Cigna — PPO: $4,162.01 Claritev (MultiPlan) — COMM: $8,007.66
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist EEG	Not listed in the file	Not listed in the file	$514.80 – $915
Sleep study (overnight, in a sleep lab): rates for 10 insurance plans Anthem — BlueChoice: $514.80 Anthem — FEP: $915 Anthem — HMO: $572 Anthem — POS: $572 Anthem — PPO: $915 Anthem Maine — BlueChoice: $1,657.80 Anthem Maine — FEP: $2,943 Anthem Maine — HMO: $1,842 Anthem Maine — POS: $1,842 Anthem Maine — PPO: $2,943
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · modifier 52 In the file: POLYSOM 1-3 PAR <6HRS	$9,886	$9,886	$407.30 – $9,391.70
Sleep study (overnight, in a sleep lab): 10 of 32 insurance plan rates Aetna — EPO: $6,257.84 Aetna — HMO: $6,257.84 Aetna — POS: $6,257.84 Aetna — PPO: $6,257.84 AmeriHealth Caritas — MCD: $407.30 Anthem — INDEMNITY: $4,379.50 Anthem Maine — INDEMNITY: $4,379.50 Cigna — HMO: $3,598.50 Cigna — PPO: $4,162.01 Claritev (MultiPlan) — COMM: $8,007.66

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexib	Not listed in the file	Not listed in the file	$28.69 – $52.74
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 16 insurance plan rates Aetna — MCR: $29.58 Anthem — MCR: $30.17 Anthem Maine — MCR: $30.17 Centene Granite State Health — HIX: $52.74 Cigna HealthSpring — MGMCR: $30.17 Evernorth Behavioral Health — MCR: $30.17 Humana — MCR: $29.58 Humana Military — TRICR: $28.69 Martin's Point Health — MCR: $30.76 Martin's Point Health — TRICR: $28.99
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GO In the file: THER EXERCISES 15 MIN OT	$245	$245	$10.09 – $232.75
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 25 insurance plan rates Aetna — EPO: $155.09 Aetna — HMO: $155.09 Aetna — POS: $155.09 Aetna — PPO: $155.09 AmeriHealth Caritas — MCD: $10.09 Anthem — INDEMNITY: $108.53 Anthem Maine — INDEMNITY: $108.53 Claritev (MultiPlan) — COMM: $198.45 CorVel — WorkersComp: $176.40 EverNorth — COMM: $196
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: THER EXERCIS 15 MIN PTCQ	$245	$245	$10.09 – $232.75
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 25 insurance plan rates Aetna — EPO: $155.09 Aetna — HMO: $155.09 Aetna — POS: $155.09 Aetna — PPO: $155.09 AmeriHealth Caritas — MCD: $10.09 Anthem — INDEMNITY: $108.53 Anthem Maine — INDEMNITY: $108.53 Claritev (MultiPlan) — COMM: $198.45 CorVel — WorkersComp: $176.40 EverNorth — COMM: $196
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact	Not listed in the file	Not listed in the file	$96.72 – $177.76
Physical therapy evaluation (low complexity): 10 of 16 insurance plan rates Aetna — MCR: $99.71 Anthem — MCR: $101.70 Anthem Maine — MCR: $101.70 Centene Granite State Health — HIX: $177.76 Cigna HealthSpring — MGMCR: $101.70 Evernorth Behavioral Health — MCR: $101.70 Humana — MCR: $99.71 Humana Military — TRICR: $96.72 Martin's Point Health — MCR: $103.70 Martin's Point Health — TRICR: $97.72
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT LOW COMPLEX	$730	$730	$30.08 – $693.50
Physical therapy evaluation (low complexity): 10 of 25 insurance plan rates Aetna — EPO: $462.09 Aetna — HMO: $462.09 Aetna — POS: $462.09 Aetna — PPO: $462.09 AmeriHealth Caritas — MCD: $30.08 Anthem — INDEMNITY: $323.39 Anthem Maine — INDEMNITY: $323.39 Claritev (MultiPlan) — COMM: $591.30 CorVel — WorkersComp: $525.60 EverNorth — COMM: $584
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact	Not listed in the file	Not listed in the file	$87.75 – $156.43
Physical therapy evaluation (low complexity): 10 of 13 insurance plan rates Aetna — MCR: $87.75 Anthem — MCR: $89.50 Anthem Maine — MCR: $89.50 Centene Granite State Health — HIX: $156.43 Cigna HealthSpring — MGMCR: $89.50 Evernorth Behavioral Health — MCR: $89.50 Humana — MCR: $87.75 Martin's Point Health — MCR: $91.25 Molina Healthcare — MCR: $100.91 United — MCR: $89.50
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or	Not listed in the file	Not listed in the file	$96.72 – $177.76
Physical therapy evaluation (moderate complexity): 10 of 16 insurance plan rates Aetna — MCR: $99.71 Anthem — MCR: $101.70 Anthem Maine — MCR: $101.70 Centene Granite State Health — HIX: $177.76 Cigna HealthSpring — MGMCR: $101.70 Evernorth Behavioral Health — MCR: $101.70 Humana — MCR: $99.71 Humana Military — TRICR: $96.72 Martin's Point Health — MCR: $103.70 Martin's Point Health — TRICR: $97.72
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT MOD COMPLEX	$730	$730	$30.08 – $693.50
Physical therapy evaluation (moderate complexity): 10 of 25 insurance plan rates Aetna — EPO: $462.09 Aetna — HMO: $462.09 Aetna — POS: $462.09 Aetna — PPO: $462.09 AmeriHealth Caritas — MCD: $30.08 Anthem — INDEMNITY: $323.39 Anthem Maine — INDEMNITY: $323.39 Claritev (MultiPlan) — COMM: $591.30 CorVel — WorkersComp: $525.60 EverNorth — COMM: $584
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or	Not listed in the file	Not listed in the file	$87.75 – $156.43
Physical therapy evaluation (moderate complexity): 10 of 13 insurance plan rates Aetna — MCR: $87.75 Anthem — MCR: $89.50 Anthem Maine — MCR: $89.50 Centene Granite State Health — HIX: $156.43 Cigna HealthSpring — MGMCR: $89.50 Evernorth Behavioral Health — MCR: $89.50 Humana — MCR: $87.75 Martin's Point Health — MCR: $91.25 Molina Healthcare — MCR: $100.91 United — MCR: $89.50
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o	Not listed in the file	Not listed in the file	$96.72 – $177.76
Physical therapy evaluation (high complexity): 10 of 16 insurance plan rates Aetna — MCR: $99.71 Anthem — MCR: $101.70 Anthem Maine — MCR: $101.70 Centene Granite State Health — HIX: $177.76 Cigna HealthSpring — MGMCR: $101.70 Evernorth Behavioral Health — MCR: $101.70 Humana — MCR: $99.71 Humana Military — TRICR: $96.72 Martin's Point Health — MCR: $103.70 Martin's Point Health — TRICR: $97.72
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT HIGH COMPLEX	$730	$730	$30.08 – $693.50
Physical therapy evaluation (high complexity): 10 of 25 insurance plan rates Aetna — EPO: $462.09 Aetna — HMO: $462.09 Aetna — POS: $462.09 Aetna — PPO: $462.09 AmeriHealth Caritas — MCD: $30.08 Anthem — INDEMNITY: $323.39 Anthem Maine — INDEMNITY: $323.39 Claritev (MultiPlan) — COMM: $591.30 CorVel — WorkersComp: $525.60 EverNorth — COMM: $584
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o	Not listed in the file	Not listed in the file	$87.75 – $156.43
Physical therapy evaluation (high complexity): 10 of 13 insurance plan rates Aetna — MCR: $87.75 Anthem — MCR: $89.50 Anthem Maine — MCR: $89.50 Centene Granite State Health — HIX: $156.43 Cigna HealthSpring — MGMCR: $89.50 Evernorth Behavioral Health — MCR: $89.50 Humana — MCR: $87.75 Martin's Point Health — MCR: $91.25 Molina Healthcare — MCR: $100.91 United — MCR: $89.50
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: INDIV SESSION 30MIN	$337	$337	$13.88 – $320.15
Psychotherapy, 30 minutes: 10 of 32 insurance plan rates Aetna — EPO: $213.32 Aetna — HMO: $213.32 Aetna — POS: $213.32 Aetna — PPO: $213.32 AmeriHealth Caritas — MCD: $13.88 Anthem — INDEMNITY: $149.29 Anthem Maine — INDEMNITY: $149.29 Cigna — HMO: $122.67 Cigna — PPO: $141.88 Claritev (MultiPlan) — COMM: $272.97
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: INDIV SESSION 45MIN	$1,007	$1,007	$41.49 – $956.65
Psychotherapy, 45 minutes: 10 of 32 insurance plan rates Aetna — EPO: $637.43 Aetna — HMO: $637.43 Aetna — POS: $637.43 Aetna — PPO: $637.43 AmeriHealth Caritas — MCD: $41.49 Anthem — INDEMNITY: $446.10 Anthem Maine — INDEMNITY: $446.10 Cigna — HMO: $366.55 Cigna — PPO: $423.95 Claritev (MultiPlan) — COMM: $815.67
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: INDIV SESSION 60MIN	$674	$674	$27.77 – $640.30
Psychotherapy, 60 minutes: 10 of 32 insurance plan rates Aetna — EPO: $426.64 Aetna — HMO: $426.64 Aetna — POS: $426.64 Aetna — PPO: $426.64 AmeriHealth Caritas — MCD: $27.77 Anthem — INDEMNITY: $298.58 Anthem Maine — INDEMNITY: $298.58 Cigna — HMO: $245.34 Cigna — PPO: $283.75 Claritev (MultiPlan) — COMM: $545.94
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: FAM WO PT 50 MIN	$1,073	$1,073	$44.21 – $1,019.35
Family psychotherapy, without the patient: 10 of 26 insurance plan rates Aetna — EPO: $679.21 Aetna — HMO: $679.21 Aetna — POS: $679.21 Aetna — PPO: $679.21 AmeriHealth Caritas — MCD: $44.21 Anthem — INDEMNITY: $475.34 Anthem Maine — INDEMNITY: $475.34 Cigna — HMO: $390.57 Cigna — PPO: $451.73 Claritev (MultiPlan) — COMM: $869.13
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: FAM W PT 50 MIN	$1,073	$1,073	$44.21 – $1,019.35
Family psychotherapy, with the patient: 10 of 26 insurance plan rates Aetna — EPO: $679.21 Aetna — HMO: $679.21 Aetna — POS: $679.21 Aetna — PPO: $679.21 AmeriHealth Caritas — MCD: $44.21 Anthem — INDEMNITY: $475.34 Anthem Maine — INDEMNITY: $475.34 Cigna — HMO: $390.57 Cigna — PPO: $451.73 Claritev (MultiPlan) — COMM: $869.13
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: IOP CD GRP (NOT FAMILY)	$496	$496	$20.44 – $471.20
Group psychotherapy: 10 of 27 insurance plan rates Aetna — EPO: $313.97 Aetna — HMO: $313.97 Aetna — POS: $313.97 Aetna — PPO: $313.97 AmeriHealth Caritas — MCD: $20.44 Anthem — INDEMNITY: $219.73 Anthem Maine — INDEMNITY: $219.73 Cigna — HMO: $180.54 Cigna — PPO: $208.82 Claritev (MultiPlan) — COMM: $401.76
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: IOP PSY GRP (NOT FAMILY)	$496	$496	$20.44 – $471.20
Group psychotherapy: 10 of 21 insurance plan rates Aetna — EPO: $313.97 Aetna — HMO: $313.97 Aetna — POS: $313.97 Aetna — PPO: $313.97 AmeriHealth Caritas — MCD: $20.44 Cigna — HMO: $180.54 Cigna — PPO: $208.82 Claritev (MultiPlan) — COMM: $401.76 CorVel — WorkersComp: $357.12 First Health — PPO: $451.36

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19	Not listed in the file	Not listed in the file	$4,686.30 – $16,924
Removal of breast growth (open surgery): 10 of 12 insurance plan rates Anthem — BlueChoice: $4,686.30 Anthem — FEP: $6,290 Anthem — HMO: $5,207 Anthem — POS: $5,207 Anthem — PPO: $6,290 Anthem Maine — BlueChoice: $4,686.30 Anthem Maine — FEP: $6,290 Anthem Maine — HMO: $5,207 Anthem Maine — POS: $5,207 Anthem Maine — PPO: $6,290
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft	Not listed in the file	Not listed in the file	$33,630.30 – $49,730
Total hip replacement: 10 of 19 insurance plan rates Anthem — BlueChoice: $33,630.30 Anthem — FEP: $49,730 Anthem — HMO: $37,367 Anthem — POS: $37,367 Anthem — PPO: $49,730 Anthem Maine — BlueChoice: $33,630.30 Anthem Maine — FEP: $49,730 Anthem Maine — HMO: $37,367 Anthem Maine — POS: $37,367 Anthem Maine — PPO: $49,730
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)	Not listed in the file	Not listed in the file	$33,630.30 – $49,730
Total knee replacement: 10 of 19 insurance plan rates Anthem — BlueChoice: $33,630.30 Anthem — FEP: $49,730 Anthem — HMO: $37,367 Anthem — POS: $37,367 Anthem — PPO: $49,730 Anthem Maine — BlueChoice: $33,630.30 Anthem Maine — FEP: $49,730 Anthem Maine — HMO: $37,367 Anthem Maine — POS: $37,367 Anthem Maine — PPO: $49,730
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) rele	Not listed in the file	Not listed in the file	$14,433 – $16,924
Shoulder arthroscopy: shaving of shoulder bone: rates for 2 insurance plans Cigna — HMO: $14,433 Cigna — PPO: $16,924
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articula	Not listed in the file	Not listed in the file	$4,686.30 – $6,290
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 12 insurance plan rates Anthem — BlueChoice: $4,686.30 Anthem — FEP: $6,290 Anthem — HMO: $5,207 Anthem — POS: $5,207 Anthem — PPO: $6,290 Anthem Maine — BlueChoice: $4,686.30 Anthem Maine — FEP: $6,290 Anthem Maine — HMO: $5,207 Anthem Maine — POS: $5,207 Anthem Maine — PPO: $6,290
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Tonsillectomy and adenoidectomy; younger than age 12	Not listed in the file	Not listed in the file	$5,604.30 – $16,924
Removal of tonsils and adenoids (under age 12): 10 of 12 insurance plan rates Anthem — BlueChoice: $5,604.30 Anthem — FEP: $9,225 Anthem — HMO: $6,227 Anthem — POS: $6,227 Anthem — PPO: $9,016 Anthem Maine — BlueChoice: $5,604.30 Anthem Maine — FEP: $9,225 Anthem Maine — HMO: $6,227 Anthem Maine — POS: $6,227 Anthem Maine — PPO: $9,016
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (sep	Not listed in the file	Not listed in the file	$1,282.50 – $6,178
Upper GI endoscopy (diagnostic): 10 of 13 insurance plan rates Anthem — BlueChoice: $1,282.50 Anthem — FEP: $3,145 Anthem — HMO: $1,425 Anthem — POS: $1,425 Anthem — PPO: $3,460 Anthem Maine — BlueChoice: $1,282.50 Anthem Maine — FEP: $3,145 Anthem Maine — HMO: $1,425 Anthem Maine — POS: $1,425 Anthem Maine — PPO: $3,460
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	Not listed in the file	Not listed in the file	$1,282.50 – $7,204
Upper GI endoscopy with biopsy: 10 of 13 insurance plan rates Anthem — BlueChoice: $1,282.50 Anthem — FEP: $3,145 Anthem — HMO: $1,425 Anthem — POS: $1,425 Anthem — PPO: $3,460 Anthem Maine — BlueChoice: $1,282.50 Anthem Maine — FEP: $3,145 Anthem Maine — HMO: $1,425 Anthem Maine — POS: $1,425 Anthem Maine — PPO: $3,460
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)	Not listed in the file	Not listed in the file	$2,000
Colonoscopy (diagnostic): 10 of 13 insurance plan rates Anthem — BlueChoice: $1,282.50 Anthem — FEP: $3,145 Anthem — HMO: $1,425 Anthem — POS: $1,425 Anthem — PPO: $3,460 Anthem Maine — BlueChoice: $1,282.50 Anthem Maine — FEP: $3,145 Anthem Maine — HMO: $1,425 Anthem Maine — POS: $1,425 Anthem Maine — PPO: $3,460
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with biopsy, single or multiple	Not listed in the file	Not listed in the file	$1,569.60 – $7,204
Colonoscopy with biopsy: 10 of 13 insurance plan rates Anthem — BlueChoice: $1,569.60 Anthem — FEP: $3,669 Anthem — HMO: $1,744 Anthem — POS: $1,744 Anthem — PPO: $3,879 Anthem Maine — BlueChoice: $1,569.60 Anthem Maine — FEP: $3,669 Anthem Maine — HMO: $1,744 Anthem Maine — POS: $1,744 Anthem Maine — PPO: $3,879
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique	Not listed in the file	Not listed in the file	$1,569.60 – $7,204
Colonoscopy with removal of polyps (snare): 10 of 13 insurance plan rates Anthem — BlueChoice: $1,569.60 Anthem — FEP: $3,669 Anthem — HMO: $1,744 Anthem — POS: $1,744 Anthem — PPO: $3,879 Anthem Maine — BlueChoice: $1,569.60 Anthem Maine — FEP: $3,669 Anthem Maine — HMO: $1,744 Anthem Maine — POS: $1,744 Anthem Maine — PPO: $3,879
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and	Not listed in the file	Not listed in the file	$1,569.60 – $7,204
Ultrasound of the lower bowel by endoscope: 10 of 13 insurance plan rates Anthem — BlueChoice: $1,569.60 Anthem — FEP: $3,669 Anthem — HMO: $1,744 Anthem — POS: $1,744 Anthem — PPO: $3,879 Anthem Maine — BlueChoice: $1,569.60 Anthem Maine — FEP: $3,669 Anthem Maine — HMO: $1,744 Anthem Maine — POS: $1,744 Anthem Maine — PPO: $3,879
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	Not listed in the file	Not listed in the file	$1,282.50 – $7,204
Screening colonoscopy (not high risk): 10 of 12 insurance plan rates Anthem — BlueChoice: $1,282.50 Anthem — FEP: $3,145 Anthem — HMO: $1,425 Anthem — POS: $1,425 Anthem — PPO: $3,460 Anthem Maine — BlueChoice: $1,282.50 Anthem Maine — FEP: $3,145 Anthem Maine — HMO: $1,425 Anthem Maine — POS: $1,425 Anthem Maine — PPO: $3,460
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical; cholecystectomy	Not listed in the file	Not listed in the file	$10,005.30 – $18,241
Gallbladder removal by laparoscope: 10 of 12 insurance plan rates Anthem — BlueChoice: $10,005.30 Anthem — FEP: $17,298 Anthem — HMO: $11,117 Anthem — POS: $11,117 Anthem — PPO: $18,241 Anthem Maine — BlueChoice: $10,005.30 Anthem Maine — FEP: $17,298 Anthem Maine — HMO: $11,117 Anthem Maine — POS: $11,117 Anthem Maine — PPO: $18,241
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Repair initial inguinal hernia, age 5 years or older; reducible	Not listed in the file	Not listed in the file	$4,686.30 – $30,146
Groin (inguinal) hernia repair, age 5 or older: 10 of 12 insurance plan rates Anthem — BlueChoice: $4,686.30 Anthem — FEP: $6,290 Anthem — HMO: $5,207 Anthem — POS: $5,207 Anthem — PPO: $6,290 Anthem Maine — BlueChoice: $4,686.30 Anthem Maine — FEP: $6,290 Anthem Maine — HMO: $5,207 Anthem Maine — POS: $5,207 Anthem Maine — PPO: $6,290
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Biopsy, prostate; needle or punch, single or multiple, any approach	Not listed in the file	Not listed in the file	$1,569.60 – $3,879
Prostate biopsy: rates for 10 insurance plans Anthem — BlueChoice: $1,569.60 Anthem — FEP: $3,669 Anthem — HMO: $1,744 Anthem — POS: $1,744 Anthem — PPO: $3,879 Anthem Maine — BlueChoice: $1,569.60 Anthem Maine — FEP: $3,669 Anthem Maine — HMO: $1,744 Anthem Maine — POS: $1,744 Anthem Maine — PPO: $3,879
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;	Not listed in the file	Not listed in the file	$10,568.70 – $19,971
Prostate removal by laparoscope (radical prostatectomy): 10 of 12 insurance plan rates Anthem — BlueChoice: $10,568.70 Anthem — FEP: $17,822 Anthem — HMO: $11,743 Anthem — POS: $11,743 Anthem — PPO: $19,971 Anthem Maine — BlueChoice: $10,568.70 Anthem Maine — FEP: $17,822 Anthem Maine — HMO: $11,743 Anthem Maine — POS: $11,743 Anthem Maine — PPO: $19,971
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C	Not listed in the file	Not listed in the file	$1,569.60 – $16,924
Hysteroscopy with biopsy of the uterus lining: 10 of 12 insurance plan rates Anthem — BlueChoice: $1,569.60 Anthem — FEP: $3,669 Anthem — HMO: $1,744 Anthem — POS: $1,744 Anthem — PPO: $3,879 Anthem Maine — BlueChoice: $1,569.60 Anthem Maine — FEP: $3,669 Anthem Maine — HMO: $1,744 Anthem Maine — POS: $1,744 Anthem Maine — PPO: $3,879
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neur	Not listed in the file	Not listed in the file	$1,282.50 – $6,178
Spinal injection, lower back (epidural), with imaging guidance: 10 of 12 insurance plan rates Anthem — BlueChoice: $1,282.50 Anthem — FEP: $3,145 Anthem — HMO: $1,425 Anthem — POS: $1,425 Anthem — PPO: $3,460 Anthem Maine — BlueChoice: $1,282.50 Anthem Maine — FEP: $3,145 Anthem Maine — HMO: $1,425 Anthem Maine — POS: $1,425 Anthem Maine — PPO: $3,460
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, sing	Not listed in the file	Not listed in the file	$1,282.50 – $3,460
Nerve root injection, lower back, with imaging guidance: 10 of 12 insurance plan rates Anthem — BlueChoice: $1,282.50 Anthem — FEP: $3,145 Anthem — HMO: $1,425 Anthem — POS: $1,425 Anthem — PPO: $3,460 Anthem Maine — BlueChoice: $1,282.50 Anthem Maine — FEP: $3,145 Anthem Maine — HMO: $1,425 Anthem Maine — POS: $1,425 Anthem Maine — PPO: $3,460
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel	Not listed in the file	Not listed in the file	$1,569.60 – $3,879
Carpal tunnel release: 10 of 12 insurance plan rates Anthem — BlueChoice: $1,569.60 Anthem — FEP: $3,669 Anthem — HMO: $1,744 Anthem — POS: $1,744 Anthem — PPO: $3,879 Anthem Maine — BlueChoice: $1,569.60 Anthem Maine — FEP: $3,669 Anthem Maine — HMO: $1,744 Anthem Maine — POS: $1,744 Anthem Maine — PPO: $3,879
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or	Not listed in the file	Not listed in the file	$1,282.50 – $7,204
Laser treatment of clouding after cataract surgery: 10 of 12 insurance plan rates Anthem — BlueChoice: $1,282.50 Anthem — FEP: $3,145 Anthem — HMO: $1,425 Anthem — POS: $1,425 Anthem — PPO: $3,460 Anthem Maine — BlueChoice: $1,282.50 Anthem Maine — FEP: $3,145 Anthem Maine — HMO: $1,425 Anthem Maine — POS: $1,425 Anthem Maine — PPO: $3,460
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irriga	Not listed in the file	Not listed in the file	$1,569.60 – $27,423
Cataract removal with lens implant: 10 of 12 insurance plan rates Anthem — BlueChoice: $1,569.60 Anthem — FEP: $3,669 Anthem — HMO: $1,744 Anthem — POS: $1,744 Anthem — PPO: $3,879 Anthem Maine — BlueChoice: $1,569.60 Anthem Maine — FEP: $3,669 Anthem Maine — HMO: $1,744 Anthem Maine — POS: $1,744 Anthem Maine — PPO: $3,879

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care	Not listed in the file	Not listed in the file	$4,686.30 – $6,290
Vaginal delivery, with care before and after: rates for 10 insurance plans Anthem — BlueChoice: $4,686.30 Anthem — FEP: $6,290 Anthem — HMO: $5,207 Anthem — POS: $5,207 Anthem — PPO: $6,290 Anthem Maine — BlueChoice: $4,686.30 Anthem Maine — FEP: $6,290 Anthem Maine — HMO: $5,207 Anthem Maine — POS: $5,207 Anthem Maine — PPO: $6,290
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, cesarean delivery, and postpartum care	Not listed in the file	Not listed in the file	$4,686.30 – $6,290
Cesarean delivery (C-section), with care before and after: rates for 10 insurance plans Anthem — BlueChoice: $4,686.30 Anthem — FEP: $6,290 Anthem — HMO: $5,207 Anthem — POS: $5,207 Anthem — PPO: $6,290 Anthem Maine — BlueChoice: $4,686.30 Anthem Maine — FEP: $6,290 Anthem Maine — HMO: $5,207 Anthem Maine — POS: $5,207 Anthem Maine — PPO: $6,290
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after p	Not listed in the file	Not listed in the file	$4,686.30 – $6,290
Vaginal delivery after a previous C-section, with care before and after: rates for 10 insurance plans Anthem — BlueChoice: $4,686.30 Anthem — FEP: $6,290 Anthem — HMO: $5,207 Anthem — POS: $5,207 Anthem — PPO: $6,290 Anthem Maine — BlueChoice: $4,686.30 Anthem Maine — FEP: $6,290 Anthem Maine — HMO: $5,207 Anthem Maine — POS: $5,207 Anthem Maine — PPO: $6,290

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA	Not listed in the file	Not listed in the file	$7,757 – $199,969
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 52 insurance plan rates Aetna — MCR: $89,921.29 AmeriHealth Caritas — MCD: $69,595.29 Anthem — BlueChoice: $83,225.70 Anthem — FEP: $177,322 Anthem — HMO: $92,473 Anthem — MCR: $91,719.72 Anthem — POS: $92,473 Anthem — PPO: $186,654 Anthem Maine — BlueChoice: $83,225.70 Anthem Maine — FEP: $177,322
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	$73,279
Spinal fusion (not neck), without major complications: rates for 2 insurance plans Cigna — HMO: $73,279 Cigna — PPO: $73,279
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT	Not listed in the file	Not listed in the file	$7,757 – $70,848
Hip or knee replacement (major joint of the leg), without major complications: 10 of 52 insurance plan rates Aetna — MCR: $18,201.41 AmeriHealth Caritas — MCD: $13,597.57 Anthem — BlueChoice: $28,541.70 Anthem — FEP: $67,305 Anthem — HMO: $31,713 Anthem — MCR: $18,565.44 Anthem — POS: $31,713 Anthem — PPO: $70,848 Anthem Maine — BlueChoice: $28,541.70 Anthem Maine — FEP: $67,305
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$4,602 – $5,752
Neck (cervical) spinal fusion, without complications: 10 of 52 insurance plan rates Aetna — MCR: $22,880.52 AmeriHealth Caritas — MCD: $17,071.42 Anthem — BlueChoice: $42,457.50 Anthem — FEP: $47,175 Anthem — HMO: $47,175 Anthem — MCR: $23,338.13 Anthem — POS: $47,175 Anthem — PPO: $47,175 Anthem Maine — BlueChoice: $42,457.50 Anthem Maine — FEP: $47,175
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$4,602 – $5,752
Uterus and ovary surgery (not for cancer), without complications: 10 of 52 insurance plan rates Aetna — MCR: $11,916.94 AmeriHealth Caritas — MCD: $8,643.88 Anthem — BlueChoice: $14,554.16 Anthem — FEP: $45,848.83 Anthem — HMO: $16,171.28 Anthem — MCR: $12,155.28 Anthem — POS: $16,171.28 Anthem — PPO: $30,182.51 Anthem Maine — BlueChoice: $14,554.16 Anthem Maine — FEP: $45,848.83

Source: Portsmouth Regional Hospital’s standard charges file (stctrprodsnsvc00455826e6.blob.core.windows.net, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on September 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Acute Care Hospital
Address	333 Borthwick Ave, Portsmouth, NH 03801
County	Rockingham County
State	New Hampshire
Phone	(603) 436‑5110
Emergency services	Yes
Ownership	Proprietary
Medicare overall rating	3 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	300029
Name in Medicare records	PORTSMOUTH REGIONAL HOSPITAL
Profile level	Medicare data + hospital website
Official website	portsmouthhospital.com
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Portsmouth Regional Hospital — portsmouthhospital.com
Specialties - Portsmouth Regional Hospital — portsmouthhospital.com
Emergency Care — portsmouthhospital.com
Visitor Services and Policies — portsmouthhospital.com
Portsmouth Regional Hospital — portsmouthhospital.com
Surgical Care | Portsmouth Regional Hospital — portsmouthhospital.com
Diagnostic Imaging | Portsmouth Regional Hospital — portsmouthhospital.com
Physical Rehabilitation | Portsmouth Regional Hospital — portsmouthhospital.com
Neurology Services | Portsmouth Regional Hospital — portsmouthhospital.com
Orthopedics | Portsmouth Regional Hospital — portsmouthhospital.com
Cardiovascular Surgery | Portsmouth Regional Hospital — portsmouthhospital.com
Cancer Care | Portsmouth Regional Hospital — portsmouthhospital.com
Labor and Delivery | Portsmouth Regional Hospital — portsmouthhospital.com
Emergency Care | Portsmouth Regional Hospital — portsmouthhospital.com
Trauma Care | Portsmouth Regional Hospital — portsmouthhospital.com
Mental & Behavioral Health | Portsmouth Regional Hospital — portsmouthhospital.com
Cardiology | Portsmouth Regional Hospital — portsmouthhospital.com
Heart Screening & Imaging | Portsmouth Regional Hospital — portsmouthhospital.com
Breast Care | Portsmouth Regional Hospital — portsmouthhospital.com

Portsmouth Regional Hospital

Summary

Profile from official sources

At a glance