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CT thoracic spine without contrast

CPT 72128 · negotiated-rate distribution across hospitals in ME

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Hospitals
5
Min
$60.85
Median
$690.16
Max
$1,063.46
Range multiplier
17.5×

By payer (24 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Anthem BCBS417$31$512.27$1,064.7334.3×
UnitedHealthcare413$29$103.15$1,692.8458.4×
Humana36$31$97.64$124.734.0×
Aetna26$91.78$578.65$1,375.1415.0×
Cigna45$650$650$1,491.122.3×
Medicare33$29$31$103.153.6×
harvard pilgrim33$730.31$730.39$757.581.0×
Medicaid33$30.31$30.31$112.433.7×
sentara health plan13$102.52$121.33$1,284.0212.5×
WellCare22$31$67.08$103.153.3×
martins point11$103.15$103.15$103.151.0×
First Health11$124.73$124.73$124.731.0×
Self-Pay (Cash)11$103.15$103.15$103.151.0×
workers compensation11$174.45$174.45$174.451.0×
TRICARE11$103.15$103.15$103.151.0×
connecticare11$1,449.7$1,449.7$1,449.71.0×
vhn11$1,656.8$1,656.8$1,656.81.0×
vhn - link11$1,863.9$1,863.9$1,863.91.0×
vhn - plus11$1,594.67$1,594.67$1,594.671.0×
vhn - secondary payors11$1,967.45$1,967.45$1,967.451.0×
gateway - tier 211$1,656.8$1,656.8$1,656.81.0×
gateway - tier 311$1,139.05$1,139.05$1,139.051.0×
gateway - tier 111$1,967.45$1,967.45$1,967.451.0×
vhn - ultra11$1,284.02$1,284.02$1,284.021.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
RUMFORD HOSPITALRUMFORDME6$2,050$594$29$690.16$963.52
BRIDGTON HOSPITALBRIDGTONME8$2,050$635$30.31$60.85$1,064.73
FRANKLIN MEMORIAL HOSPITALFARMINGTONME16$2,071$724.85$91.78$1,063.46$1,967.45
CENTRAL MAINE MEDICAL CENTERLEWISTONME13$2,050$103$103.15$103.15$757.58
REDINGTON-FAIRVIEW GENERAL HOSPITALSKOWHEGANME0$1,308$981

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.