SelfPayRates — hospital cash prices, from the source
Cash prices at 1 facility for code 99204, as an outpatient — the setting a self-pay patient normally buys. Collected Sep 23, 2026; the hospital files themselves were last updated between Sep 9, 2025 and Sep 9, 2025.
| Hospital | Cash price | List price | Off | File date | |
|---|---|---|---|---|---|
| MaineHealth
BELFAST, ME HC OFFICE/OUTPT NEW LEV 4 - WOUND CARE CENTER |
$161.95 | $161.95 | — | Sep 9, 2025 file |
|
| MaineHealth
BELFAST, ME PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES - WOUND CARE |
$341.45 | $341.45 | — | Sep 9, 2025 file |
|
| MaineHealth
BELFAST, ME HC OFFICE/OUTPT NEW LEV 4 |
$355.00 | $355.00 | — | Sep 9, 2025 file |
|
| MaineHealth
BELFAST, ME PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES |
$680.20 | $680.20 | — | Sep 9, 2025 file |
Outpatient: lowest $161.95, median $348.23, highest $680.20 — a 4.2× difference within the same market.
As an inpatient, the same code is billed by 1 facility here, median $348.23. Inpatient and outpatient prices are not comparable and are kept on separate pages: the inpatient charge covers admission, not the same purchase.