Level 2 Musculoskeletal Procedures in Maine
What 17 hospitals in Maine charged and were paid for level 2 musculoskeletal procedures (APC 5112), from 2024 Medicare claims.
Average charge
$6,689
Hospital list price billed
Average allowed
$1,451
Medicare's payment + patient's share
Medicare paid
$1,149
Average per service
State rank
#25 of 49
1 = lowest average payment
Hospitals in Maine billed an average of $6,689 for level 2 musculoskeletal procedures, about 4.6 times the average medicare-allowed amount of $1,451. That payment is 4% below the U.S. average of $1,511.
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 $1,451Billed $6,689
About 22¢ was paid for every $1 hospitals in Maine billed for this service.
Maine hospitals: level 2 musculoskeletal 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 | 87 | $6,689 | $1,482 | $1,174 |
| Maine General Medical CenterWaterville | 41 | $3,828 | $1,578 | $1,255 |
| Mid Coast HospitalBrunswick | 30 | $6,225 | $1,510 | $1,203 |
| Mercy HospitalPortland | 29 | $6,565 | $1,469 | $1,155 |
| York HospitalYork | 28 | $7,038 | $1,471 | $1,160 |
| Eastern Maine Medical CenterBangor | 23 | $9,785 | $1,400 | $1,116 |
| Maine Coast Memorial HospitalEllsworth | 19 | $4,887 | $975 | $769 |
| St Marys Regional Medical CenterLewiston | 16 | $12,719 | $1,395 | $1,111 |
| Penobscot Bay Medical CenterRockport | 16 | $6,498 | $1,404 | $1,097 |
| Southern Maine Health CareBiddeford | 14 | $6,898 | $1,510 | $1,198 |
| Northern Maine Medical CenterFort Kent | 12 | $5,989 | $1,477 | $1,168 |
| St Joseph HospitalBangor | – | – | – | – |
| Northern Light a R Gould HospitalPresque Isle | – | – | – | – |
| Central Maine Medical CenterLewiston | – | – | – | – |
| Cary Medical CenterCaribou | – | – | – | – |
| Franklin Memorial HospitalFarmington | – | – | – | – |
| Northern Light Inland HospitalWaterville | – | – | – | – |
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
| Maine Coast Memorial HospitalEllsworth, ME | $975 |
|---|---|
| St Marys Regional Medical CenterLewiston, ME | $1,395 |
| Eastern Maine Medical CenterBangor, ME | $1,400 |
| Penobscot Bay Medical CenterRockport, ME | $1,404 |
| Mercy HospitalPortland, ME | $1,469 |
Highest
| Maine General Medical CenterWaterville, ME | $1,578 |
|---|---|
| Southern Maine Health CareBiddeford, ME | $1,510 |
| Mid Coast HospitalBrunswick, ME | $1,510 |
| Maine Medical CenterPortland, ME | $1,482 |
| Northern Maine Medical CenterFort Kent, ME | $1,477 |
Level 2 Musculoskeletal Procedures in other states
Questions
How much does level 2 musculoskeletal procedures cost in Maine?
In 2024 Medicare data, level 2 musculoskeletal procedures (APC 5112) at 17 hospitals in Maine was billed at $6,689 on average, while the average medicare-allowed amount was $1,451, of which Medicare paid $1,149. 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 4.6 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.