Level 1 Intraocular Procedures in Maine
What 8 hospitals in Maine charged and were paid for level 1 intraocular procedures (APC 5491), from 2024 Medicare claims.
Average charge
$10,362
Hospital list price billed
Average allowed
$2,121
Medicare's payment + patient's share
Medicare paid
$1,685
Average per service
State rank
#27 of 49
1 = lowest average payment
Hospitals in Maine billed an average of $10,362 for level 1 intraocular procedures, about 4.9 times the average medicare-allowed amount of $2,121. That payment is 4% below the U.S. average of $2,208.
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 $2,121Billed $10,362
About 20¢ was paid for every $1 hospitals in Maine billed for this service.
Maine hospitals: level 1 intraocular 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 |
|---|---|---|---|---|
| Mid Coast HospitalBrunswick | 332 | $9,956 | $2,179 | $1,731 |
| Northern Light a R Gould HospitalPresque Isle | 225 | $9,012 | $1,971 | $1,564 |
| Maine General Medical CenterWaterville | 100 | $15,209 | $2,288 | $1,822 |
| Penobscot Bay Medical CenterRockport | 78 | $11,796 | $2,142 | $1,702 |
| Cary Medical CenterCaribou | 46 | $6,905 | $2,000 | $1,591 |
| Northern Maine Medical CenterFort Kent | 46 | $9,185 | $2,142 | $1,704 |
| Franklin Memorial HospitalFarmington | 18 | $13,444 | $2,145 | $1,699 |
| Southern Maine Health CareBiddeford | – | – | – | – |
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
| Northern Light a R Gould HospitalPresque Isle, ME | $1,971 |
|---|---|
| Cary Medical CenterCaribou, ME | $2,000 |
| Northern Maine Medical CenterFort Kent, ME | $2,142 |
| Penobscot Bay Medical CenterRockport, ME | $2,142 |
| Franklin Memorial HospitalFarmington, ME | $2,145 |
Highest
| Maine General Medical CenterWaterville, ME | $2,288 |
|---|---|
| Mid Coast HospitalBrunswick, ME | $2,179 |
| Franklin Memorial HospitalFarmington, ME | $2,145 |
| Penobscot Bay Medical CenterRockport, ME | $2,142 |
| Northern Maine Medical CenterFort Kent, ME | $2,142 |
Level 1 Intraocular Procedures in other states
Questions
How much does level 1 intraocular procedures cost in Maine?
In 2024 Medicare data, level 1 intraocular procedures (APC 5491) at 8 hospitals in Maine was billed at $10,362 on average, while the average medicare-allowed amount was $2,121, of which Medicare paid $1,685. 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 4.9 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.