Level 1 Breast/Lymphatic Surgery and Related Procedures in Maine
What 15 hospitals in Maine charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.
Average charge
$19,044
Hospital list price billed
Average allowed
$3,457
Medicare's payment + patient's share
Medicare paid
$2,743
Average per service
State rank
#24 of 49
1 = lowest average payment
Hospitals in Maine billed an average of $19,044 for level 1 breast/lymphatic surgery and related procedures, about 5.5 times the average medicare-allowed amount of $3,457. That payment is 6% below the U.S. average of $3,688.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $3,457Billed $19,044
About 18¢ was paid for every $1 hospitals in Maine billed for this service.
Maine hospitals: level 1 breast/lymphatic surgery and related procedures
Every Maine hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Maine Medical CenterPortland | 71 | $17,497 | $3,461 | $2,733 |
| Eastern Maine Medical CenterBangor | 64 | $20,823 | $3,321 | $2,645 |
| York HospitalYork | 28 | $19,022 | $3,581 | $2,853 |
| Central Maine Medical CenterLewiston | 28 | $19,438 | $3,423 | $2,700 |
| Mercy HospitalPortland | 18 | $16,219 | $3,581 | $2,853 |
| Maine General Medical CenterWaterville | 13 | $21,851 | $3,742 | $2,982 |
| St Joseph HospitalBangor | – | – | – | – |
| Northern Light a R Gould HospitalPresque Isle | – | – | – | – |
| Southern Maine Health CareBiddeford | – | – | – | – |
| Mid Coast HospitalBrunswick | – | – | – | – |
| Cary Medical CenterCaribou | – | – | – | – |
| Franklin Memorial HospitalFarmington | – | – | – | – |
| Northern Light Inland HospitalWaterville | – | – | – | – |
| Maine Coast Memorial HospitalEllsworth | – | – | – | – |
| Penobscot Bay Medical CenterRockport | – | – | – | – |
Lowest and highest allowed amounts in Maine
Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Eastern Maine Medical CenterBangor, ME | $3,321 |
|---|---|
| Central Maine Medical CenterLewiston, ME | $3,423 |
| Maine Medical CenterPortland, ME | $3,461 |
| Mercy HospitalPortland, ME | $3,581 |
| York HospitalYork, ME | $3,581 |
Highest
| Maine General Medical CenterWaterville, ME | $3,742 |
|---|---|
| Mercy HospitalPortland, ME | $3,581 |
| York HospitalYork, ME | $3,581 |
| Maine Medical CenterPortland, ME | $3,461 |
| Central Maine Medical CenterLewiston, ME | $3,423 |
Level 1 Breast/Lymphatic Surgery and Related Procedures in other states
Questions
How much does level 1 breast/lymphatic surgery and related procedures cost in Maine?
In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 15 hospitals in Maine was billed at $19,044 on average, while the average medicare-allowed amount was $3,457, of which Medicare paid $2,743. Your own cost depends on your insurance, deductible and the hospital.
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this service in Maine, average charges were 5.5 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Outpatient Hospitals by Provider and Service, 2024. The allowed amount is Medicare's payment plus the patient's coinsurance. CMS omits hospitals with fewer than 11 services for privacy. About the data.