Level 4 Musculoskeletal Procedures in Maine
What 17 hospitals in Maine charged and were paid for level 4 musculoskeletal procedures (APC 5114), from 2024 Medicare claims.
Average charge
$31,132
Hospital list price billed
Average allowed
$6,469
Medicare's payment + patient's share
Medicare paid
$5,130
Average per service
State rank
#25 of 49
1 = lowest average payment
Hospitals in Maine billed an average of $31,132 for level 4 musculoskeletal procedures, about 4.8 times the average medicare-allowed amount of $6,469. That payment is 4% below the U.S. average of $6,708.
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 $6,469Billed $31,132
About 21¢ was paid for every $1 hospitals in Maine billed for this service.
Maine hospitals: level 4 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 | 207 | $30,610 | $6,618 | $5,252 |
| Mercy HospitalPortland | 154 | $27,429 | $6,652 | $5,286 |
| Eastern Maine Medical CenterBangor | 129 | $25,999 | $6,079 | $4,809 |
| Maine General Medical CenterWaterville | 83 | $34,734 | $6,823 | $5,392 |
| St Joseph HospitalBangor | 78 | $30,212 | $6,139 | $4,891 |
| Mid Coast HospitalBrunswick | 55 | $34,541 | $6,722 | $5,354 |
| St Marys Regional Medical CenterLewiston | 42 | $47,454 | $6,094 | $4,822 |
| York HospitalYork | 39 | $30,546 | $6,584 | $5,218 |
| Central Maine Medical CenterLewiston | 34 | $28,245 | $6,612 | $5,263 |
| Southern Maine Health CareBiddeford | 29 | $33,849 | $6,168 | $4,799 |
| Penobscot Bay Medical CenterRockport | 19 | $32,660 | $6,574 | $5,238 |
| Northern Light a R Gould HospitalPresque Isle | 15 | $46,090 | $6,139 | $4,891 |
| Northern Light Inland HospitalWaterville | 13 | $33,396 | $5,863 | $4,591 |
| Cary Medical CenterCaribou | – | – | – | – |
| Franklin Memorial HospitalFarmington | – | – | – | – |
| 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
| Northern Light Inland HospitalWaterville, ME | $5,863 |
|---|---|
| Eastern Maine Medical CenterBangor, ME | $6,079 |
| St Marys Regional Medical CenterLewiston, ME | $6,094 |
| St Joseph HospitalBangor, ME | $6,139 |
| Northern Light a R Gould HospitalPresque Isle, ME | $6,139 |
Highest
| Maine General Medical CenterWaterville, ME | $6,823 |
|---|---|
| Mid Coast HospitalBrunswick, ME | $6,722 |
| Mercy HospitalPortland, ME | $6,652 |
| Maine Medical CenterPortland, ME | $6,618 |
| Central Maine Medical CenterLewiston, ME | $6,612 |
Level 4 Musculoskeletal Procedures in other states
Questions
How much does level 4 musculoskeletal procedures cost in Maine?
In 2024 Medicare data, level 4 musculoskeletal procedures (APC 5114) at 17 hospitals in Maine was billed at $31,132 on average, while the average medicare-allowed amount was $6,469, of which Medicare paid $5,130. 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.