Level 2 Upper GI Procedures in Maine
What 17 hospitals in Maine charged and were paid for level 2 upper gi procedures (APC 5302), from 2024 Medicare claims.
Average charge
$8,372
Hospital list price billed
Average allowed
$1,741
Medicare's payment + patient's share
Medicare paid
$1,387
Average per service
State rank
#25 of 49
1 = lowest average payment
Hospitals in Maine billed an average of $8,372 for level 2 upper gi procedures, about 4.8 times the average medicare-allowed amount of $1,741. That payment is 4% below the U.S. average of $1,815.
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 $1,741Billed $8,372
About 21¢ was paid for every $1 hospitals in Maine billed for this service.
Maine hospitals: level 2 upper gi 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 | 249 | $7,981 | $1,776 | $1,416 |
| Maine General Medical CenterWaterville | 141 | $8,075 | $1,818 | $1,445 |
| Eastern Maine Medical CenterBangor | 128 | $9,935 | $1,641 | $1,308 |
| St Joseph HospitalBangor | 100 | $10,572 | $1,607 | $1,278 |
| Central Maine Medical CenterLewiston | 97 | $9,348 | $1,759 | $1,399 |
| Mid Coast HospitalBrunswick | 94 | $5,905 | $1,757 | $1,401 |
| York HospitalYork | 92 | $7,300 | $1,788 | $1,434 |
| Penobscot Bay Medical CenterRockport | 57 | $5,497 | $1,724 | $1,370 |
| Mercy HospitalPortland | 47 | $10,310 | $1,788 | $1,426 |
| Southern Maine Health CareBiddeford | 17 | $8,053 | $1,704 | $1,346 |
| St Marys Regional Medical CenterLewiston | 16 | $10,477 | $1,652 | $1,321 |
| Northern Light a R Gould HospitalPresque Isle | – | – | – | – |
| Cary Medical CenterCaribou | – | – | – | – |
| Franklin Memorial HospitalFarmington | – | – | – | – |
| Northern Light Inland HospitalWaterville | – | – | – | – |
| Maine Coast Memorial HospitalEllsworth | – | – | – | – |
| Northern Maine Medical CenterFort Kent | – | – | – | – |
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
| St Joseph HospitalBangor, ME | $1,607 |
|---|---|
| Eastern Maine Medical CenterBangor, ME | $1,641 |
| St Marys Regional Medical CenterLewiston, ME | $1,652 |
| Southern Maine Health CareBiddeford, ME | $1,704 |
| Penobscot Bay Medical CenterRockport, ME | $1,724 |
Highest
| Maine General Medical CenterWaterville, ME | $1,818 |
|---|---|
| Mercy HospitalPortland, ME | $1,788 |
| York HospitalYork, ME | $1,788 |
| Maine Medical CenterPortland, ME | $1,776 |
| Central Maine Medical CenterLewiston, ME | $1,759 |
Level 2 Upper GI Procedures in other states
Questions
How much does level 2 upper gi procedures cost in Maine?
In 2024 Medicare data, level 2 upper gi procedures (APC 5302) at 17 hospitals in Maine was billed at $8,372 on average, while the average medicare-allowed amount was $1,741, of which Medicare paid $1,387. 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 4.8 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.