Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC FNA BX W/O IMG GDN EA ADDL LES
Belfast, ME
See all hospitals reporting CPT 10004 →Price type
MaineHealth’s median price of $122 is 73% below the median hospital's median price ($461), higher than 28% of the 1,449 hospitals reporting CPT 10004. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 26 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Aetna mhaco government fee schedule · both | $41.08 | $41.08 | $41.08 – $41.08 |
| 2 | Anthem medicare advantage fee schedule · both | $41.08 | $41.08 | $41.08 – $41.08 |
| 3 | Aetna medicare advantage fee schedule · both | $47.24 | $47.24 | $47.24 – $47.24 |
| 4 | Humana medicare advantage fee schedule · both | $47.24 | $47.24 | $47.24 – $47.24 |
| 5 | UnitedHealthcare medicare advantage fee schedule · both | $47.24 | $47.24 | $47.24 – $47.24 |
| 6 | WellCare medicare advantage fee schedule · both | $49.13 | $49.13 | $49.13 – $49.13 |
| 7 | Aetna hmo/ppo fee schedule · both | $56.01 | $56.01 | $56.01 – $56.01 |
| 8 | MultiPlan commercial fee schedule · both | $76.72 | $76.72 | $76.72 – $76.72 |
| 9 | UnitedHealthcare commercial fee schedule · both | $80.76 | $80.76 | $80.76 – $80.76 |
| 10 | Aetna mhaco commercial fee schedule · both | $84.24 | $84.24 | $84.24 – $84.24 |
| 11 | Anthem hmo/pos/ppo pathway enhanced fee schedule · both | $87.11 | $87.11 | $87.11 – $87.11 |
| 12 | Cigna commercial fee schedule · both | $91.08 | $91.08 | $91.08 – $91.08 |
| 13 | Anthem medicare advantage percent of total billed charges · outpatientfrom % of charges | $119.81 | $119.81 | $119.81 – $119.81 |
| 14 | Aetna medicare advantage percent of total billed charges · outpatientfrom % of charges | $122.28 | $122.28 | $122.28 – $122.28 |
| 15 | Humana medicare advantage percent of total billed charges · outpatientfrom % of charges | $122.28 | $122.28 | $122.28 – $122.28 |
| 16 | UnitedHealthcare medicare advantage percent of total billed charges · outpatientfrom % of charges | $122.28 | $122.28 | $122.28 – $122.28 |
| 17 | WellCare medicare advantage percent of total billed charges · outpatientfrom % of charges | $127.17 | $127.17 | $127.17 – $127.17 |
| 18 | Anthem hmo/pos/ppo pathway enhanced percent of total billed charges · inpatientfrom % of charges | $265.41 | $265.41 | $265.41 – $265.41 |
| 19 | Aetna hmo/ppo percent of total billed charges · inpatientfrom % of charges | $270.10 | $270.10 | $270.10 – $270.10 |
| 20 | Aetna hmo/ppo percent of total billed charges · outpatientfrom % of charges | $270.10 | $270.10 | $270.10 – $270.10 |
| 21 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $280.36 | $280.36 | $280.36 – $280.36 |
| 22 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $280.36 | $280.36 | $280.36 – $280.36 |
| 23 | UnitedHealthcare commercial percent of total billed charges · inpatientfrom % of charges | $280.68 | $280.68 | $280.68 – $280.68 |
| 24 | UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges | $280.68 | $280.68 | $280.68 – $280.68 |
| 25 | Cigna commercial percent of total billed charges · inpatientfrom % of charges | $280.95 | $280.95 | $280.95 – $280.95 |
Last updated: Sep 9, 2025
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