Diagnostic radiology · Maine

Diagnostic radiology commercial reimbursement in Maine

How Maine diagnostic radiology rates compare with the national market.

Diagnostic radiology in Maine

49 codes · 127 sampled providers
Index vs national
103
3% above
Rank among states
19 of 51
1 = highest
Codes above national
31 of 49
median code at 103%
Providers
127
sampled

What the data shows

1

Diagnostic radiology ranks 19th of 51 states in Maine with an index of 103 (100 = the specialty's national median), across 49 codes and 127 sampled providers.

2

Of the 49 diagnostic radiology codes with enough data in Maine, 31 pay above the national median and 18 below; the typical code sits at 103% of the national median.

3

Largest premium over the national median: CPT 77049 (Mri breast c-+ w/cad bi) at 130%; largest discount: CPT 70450 (Ct head/brain w/o dye) at 88%.

4

Measured against Medicare, Maine diagnostic radiology rates have a median of 151% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeMaineNationalGapProv.
77049
Mri breast c-+ w/cad bi
$726$558+30%127
93000
Electrocardiogram complete
$29$25+16%127
99205
Office o/p new hi 60 min
$282$244+16%127
72158
Mri lumbar spine w/o & w/dye
$680$593+15%127
73502
X-ray exam hip uni 2-3 views
$70$61+14%127

Lowest vs national

CodeMaineNationalGapProv.
70450
Ct head/brain w/o dye
$170$194-12%127
72131
Ct lumbar spine w/o dye
$220$248-11%127
71250
Ct thorax dx c-
$225$250-10%127
72125
Ct neck spine w/o dye
$228$249-8%127
70498
Ct angiography neck
$421$459-8%127

All diagnostic radiology codes in Maine

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeMaineNationalGap% of MedicareProvidersTINsLevel
CPT 77049
Mri breast c-+ w/cad bi
$726$558+30%214%127327
CPT 93000
Electrocardiogram complete
$29$25+16%188%127311
CPT 99205
Office o/p new hi 60 min
$282$244+16%119%127332
CPT 72158
Mri lumbar spine w/o & w/dye
$680$593+15%214%127315
CPT 73502
X-ray exam hip uni 2-3 views
$70$61+14%144%127322
CPT 73221
Mri joint upr extrem w/o dye
$464$407+14%226%127316
CPT 99213
Office o/p est low 20 min
$100$88+14%105%127337
CPT 73721
Mri jnt of lwr extre w/o dye
$462$407+14%226%127315
CPT 74183
Mri abd w/o cntr flwd cntr
$718$634+13%214%127310
CPT 70553
Mri brain stem w/o & w/dye
$678$600+13%214%127314
CPT 72197
Mri pelvis w/o & w/dye
$715$634+13%214%127311
CPT 99212
Office o/p est sf 10 min
$57$50+12%95%127333
CPT 71045
X-ray exam chest 1 view
$37$33+12%144%127320
CPT 99204
Office o/p new mod 45 min
$207$187+11%117%127337
CPT 72141
Mri neck spine w/o dye
$432$390+11%227%127317
CPT 99214
Office o/p est mod 30 min
$142$128+11%105%127333
CPT 72148
Mri lumbar spine w/o dye
$435$392+11%227%127318
CPT 70551
Mri brain stem w/o dye
$443$402+10%227%127317
CPT 99215
Office o/p est hi 40 min
$200$182+10%104%127336
CPT 99203
Office o/p new low 30 min
$129$121+7%110%127334
CPT 71046
X-ray exam chest 2 views
$48$45+6%144%127320
CPT 20610
Drain/inj joint/bursa w/o us
$87$83+5%127%127341
CPT 93970
Extremity study
$283$270+5%154%127339
CPT 76700
Us exam abdom complete
$173$168+3%152%127321
CPT 93880
Extracranial bilat study
$285$277+3%151%127317
CPT 76705
Echo exam of abdomen
$128$126+2%149%127321
CPT 76770
Us exam abdo back wall comp
$161$158+2%152%127320
CPT 76536
Us exam of head and neck
$156$154+1%144%127322
CPT 37243
Vasc embolize/occlude organ
$869$858+1%180%127320
CPT 93971
Extremity study
$173$172+0%149%127340
CPT 77066
Dx mammo incl cad bi
$226$225+0%144%127337
CPT 76642
Ultrasound breast limited
$120$120+0%144%127318
CPT 77065
Dx mammo incl cad uni
$179$179+0%144%127321
CPT 77067
Scr mammo bi incl cad
$182$182+0%144%127319
CPT 76641
Ultrasound breast complete
$144$145-1%144%127312
CPT 74177
Ct abd & pelvis w/contrast
$439$448-2%146%127313
CPT 74178
Ct abd&plv wo cntr flwd cntr
$496$520-5%147%127314
CPT 77080
Dxa bone density axial
$62$66-6%159%127318
CPT 74176
Ct abd & pelvis w/o contrast
$269$287-6%147%127314
CPT 74174
Cta abd&plvs w/contrast
$560$601-7%148%127316
CPT 71271
Ct thorax lung cancer scr c-
$193$208-7%142%127333
CPT 71260
Ct thorax dx c+
$290$312-7%174%127311
CPT 70496
Ct angiography head
$422$457-8%154%127316
CPT 71275
Ct angiography chest
$425$462-8%151%127315
CPT 70498
Ct angiography neck
$421$459-8%154%127314
CPT 72125
Ct neck spine w/o dye
$228$249-8%175%127314
CPT 71250
Ct thorax dx c-
$225$250-10%170%127315
CPT 72131
Ct lumbar spine w/o dye
$220$248-11%170%127317
CPT 70450
Ct head/brain w/o dye
$170$194-12%160%127316

Frequently asked questions

How do Maine diagnostic radiology rates compare with the rest of the country?

Maine ranks 19th of 51 states with an index of 103; 31 of 49 codes are above the national median.

Which diagnostic radiology code has the biggest premium in Maine?

CPT 77049 (Mri breast c-+ w/cad bi), at 130% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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