Level 3 Lower GI Procedures in Maine
What 16 hospitals in Maine charged and were paid for level 3 lower gi procedures (APC 5313), from 2024 Medicare claims.
Average charge
$11,247
Hospital list price billed
Average allowed
$2,586
Medicare's payment + patient's share
Medicare paid
$2,109
Average per service
State rank
#27 of 49
1 = lowest average payment
Hospitals in Maine billed an average of $11,247 for level 3 lower gi procedures, about 4.3 times the average medicare-allowed amount of $2,586. That payment is 4% below the U.S. average of $2,703.
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 $2,586Billed $11,247
About 23¢ was paid for every $1 hospitals in Maine billed for this service.
Maine hospitals: level 3 lower 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 General Medical CenterWaterville | 54 | $10,865 | $2,729 | $2,270 |
| Eastern Maine Medical CenterBangor | 51 | $12,215 | $2,446 | $1,978 |
| Maine Medical CenterPortland | 45 | $9,163 | $2,591 | $2,086 |
| Central Maine Medical CenterLewiston | 20 | $11,692 | $2,594 | $2,106 |
| Mercy HospitalPortland | 14 | $14,864 | $2,638 | $2,130 |
| Southern Maine Health CareBiddeford | 11 | $11,745 | $2,433 | $1,994 |
| St Joseph HospitalBangor | – | – | – | – |
| Northern Light a R Gould HospitalPresque Isle | – | – | – | – |
| York HospitalYork | – | – | – | – |
| Mid Coast HospitalBrunswick | – | – | – | – |
| Cary Medical CenterCaribou | – | – | – | – |
| St Marys Regional Medical CenterLewiston | – | – | – | – |
| Northern Light Inland HospitalWaterville | – | – | – | – |
| Maine Coast Memorial HospitalEllsworth | – | – | – | – |
| Northern Maine Medical CenterFort Kent | – | – | – | – |
| 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
| Southern Maine Health CareBiddeford, ME | $2,433 |
|---|---|
| Eastern Maine Medical CenterBangor, ME | $2,446 |
| Maine Medical CenterPortland, ME | $2,591 |
| Central Maine Medical CenterLewiston, ME | $2,594 |
| Mercy HospitalPortland, ME | $2,638 |
Highest
| Maine General Medical CenterWaterville, ME | $2,729 |
|---|---|
| Mercy HospitalPortland, ME | $2,638 |
| Central Maine Medical CenterLewiston, ME | $2,594 |
| Maine Medical CenterPortland, ME | $2,591 |
| Eastern Maine Medical CenterBangor, ME | $2,446 |
Level 3 Lower GI Procedures in other states
Questions
How much does level 3 lower gi procedures cost in Maine?
In 2024 Medicare data, level 3 lower gi procedures (APC 5313) at 16 hospitals in Maine was billed at $11,247 on average, while the average medicare-allowed amount was $2,586, of which Medicare paid $2,109. 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 4.3 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.