CT scan of chest and spine without contrast dye at Sebasticook Valley Health

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Ct chest spine w/o dye

Pittsfield, ME

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How this price compares nationally

Sebasticook Valley Health’s median price of $107 is 68% below the median hospital's median price ($334), higher than 7% of the 2,605 hospitals reporting CPT 72128. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 72128 at Sebasticook Valley Health

Negotiated rates from the hospital’s own file: 5 payers, 45 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 mcr advantage facility · case rate · outpatient	$51.40	$51.40	$51.40 – $51.40
2	UnitedHealthcare mcr advantage facility · case rate · outpatient	$51.40	$51.40	$51.40 – $51.40
3	WellCare mcr advantage facility · case rate · outpatient	$51.40	$51.40	$51.40 – $51.40
4	Anthem mcr advantage facility · case rate · outpatient	$51.90	$51.90	$51.90 – $51.90
5	Aetna mcr advantage professional · fee schedule · outpatient	$59.52	$59.52	$43.82 – $75.22
6	Anthem mcr advantage professional · fee schedule · outpatient	$59.52	$59.52	$43.82 – $75.22
7	UnitedHealthcare mcr advantage professional · fee schedule · outpatient	$60.71	$60.71	$44.70 – $76.72
8	WellCare mcr advantage professional · fee schedule · outpatient	$60.71	$60.71	$44.70 – $76.72
9	Aetna mcr advantage professional · percent of total billed charges · outpatientfrom % of charges	$62.32	$62.32	$62.32 – $62.32
10	Anthem mcr advantage professional · percent of total billed charges · outpatientfrom % of charges	$62.32	$62.32	$62.32 – $62.32
11	UnitedHealthcare mcr advantage professional · percent of total billed charges · outpatientfrom % of charges	$62.32	$62.32	$62.32 – $62.32
12	WellCare mcr advantage professional · percent of total billed charges · outpatientfrom % of charges	$62.32	$62.32	$62.32 – $62.32
13	Aetna commercial professional · fee schedule · outpatient	$104.17	$104.17	$76.69 – $131.64
14	Anthem commercial professional · percent of total billed charges · inpatientfrom % of charges	$106.60	$106.60	$106.60 – $106.60
15	Anthem commercial professional · percent of total billed charges · outpatientfrom % of charges	$106.60	$106.60	$106.60 – $106.60
16	Anthem enhanced pathways professional · percent of total billed charges · inpatientfrom % of charges	$106.60	$106.60	$106.60 – $106.60
17	Anthem enhanced pathways professional · percent of total billed charges · outpatientfrom % of charges	$106.60	$106.60	$106.60 – $106.60
18	Aetna commercial professional · percent of total billed charges · outpatientfrom % of charges	$110.70	$110.70	$110.70 – $110.70
19	UnitedHealthcare commercial professional · percent of total billed charges · inpatientfrom % of charges	$118.90	$118.90	$118.90 – $118.90
20	Cigna commercial professional · percent of total billed charges · inpatientfrom % of charges	$122.34	$122.34	$122.34 – $122.34
21	Cigna commercial professional · percent of total billed charges · outpatientfrom % of charges	$122.34	$122.34	$122.34 – $122.34
22	Aetna commercial professional · percent of total billed charges · inpatientfrom % of charges	$123.00	$123.00	$123.00 – $123.00
23	UnitedHealthcare commercial professional · percent of total billed charges · outpatientfrom % of charges	$123.82	$123.82	$123.82 – $123.82
24	Anthem commercial professional · fee schedule · outpatient	$123.94	$123.94	$87.86 – $160.01
25	Anthem enhanced pathways professional · fee schedule · outpatient	$123.94	$123.94	$87.86 – $160.01

Page 1 of 2 · 45 rates

Last updated: Mar 30, 2026

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