Level 3 Musculoskeletal Procedures in Maine
What 17 hospitals in Maine charged and were paid for level 3 musculoskeletal procedures (APC 5113), from 2024 Medicare claims.
Average charge
$16,204
Hospital list price billed
Average allowed
$2,895
Medicare's payment + patient's share
Medicare paid
$2,293
Average per service
State rank
#26 of 49
1 = lowest average payment
Hospitals in Maine billed an average of $16,204 for level 3 musculoskeletal procedures, about 5.6 times the average medicare-allowed amount of $2,895. That payment is 3% below the U.S. average of $2,995.
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 $2,895Billed $16,204
About 18¢ was paid for every $1 hospitals in Maine billed for this service.
Maine hospitals: level 3 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 | 118 | $13,802 | $2,898 | $2,279 |
| Maine General Medical CenterWaterville | 74 | $16,453 | $3,135 | $2,498 |
| Mercy HospitalPortland | 59 | $13,776 | $3,041 | $2,423 |
| St Joseph HospitalBangor | 55 | $19,472 | $2,777 | $2,213 |
| Mid Coast HospitalBrunswick | 52 | $12,424 | $2,952 | $2,330 |
| Eastern Maine Medical CenterBangor | 50 | $16,877 | $2,731 | $2,157 |
| Northern Light a R Gould HospitalPresque Isle | 38 | $21,440 | $2,724 | $2,155 |
| Southern Maine Health CareBiddeford | 36 | $18,643 | $2,907 | $2,287 |
| York HospitalYork | 30 | $13,952 | $3,041 | $2,423 |
| Maine Coast Memorial HospitalEllsworth | 22 | $16,443 | $2,641 | $2,104 |
| St Marys Regional Medical CenterLewiston | 17 | $29,552 | $2,810 | $2,239 |
| Northern Light Inland HospitalWaterville | 16 | $14,900 | $2,685 | $2,111 |
| Central Maine Medical CenterLewiston | 13 | $16,135 | $2,762 | $2,200 |
| Cary Medical CenterCaribou | 11 | $12,748 | $2,777 | $2,213 |
| Franklin Memorial HospitalFarmington | – | – | – | – |
| 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
| Maine Coast Memorial HospitalEllsworth, ME | $2,641 |
|---|---|
| Northern Light Inland HospitalWaterville, ME | $2,685 |
| Northern Light a R Gould HospitalPresque Isle, ME | $2,724 |
| Eastern Maine Medical CenterBangor, ME | $2,731 |
| Central Maine Medical CenterLewiston, ME | $2,762 |
Highest
| Maine General Medical CenterWaterville, ME | $3,135 |
|---|---|
| York HospitalYork, ME | $3,041 |
| Mercy HospitalPortland, ME | $3,041 |
| Mid Coast HospitalBrunswick, ME | $2,952 |
| Southern Maine Health CareBiddeford, ME | $2,907 |
Level 3 Musculoskeletal Procedures in other states
Questions
How much does level 3 musculoskeletal procedures cost in Maine?
In 2024 Medicare data, level 3 musculoskeletal procedures (APC 5113) at 17 hospitals in Maine was billed at $16,204 on average, while the average medicare-allowed amount was $2,895, of which Medicare paid $2,293. 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 5.6 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.