Level 6 Musculoskeletal Procedures in Maine
What 14 hospitals in Maine charged and were paid for level 6 musculoskeletal procedures (APC 5116), from 2024 Medicare claims.
Average charge
$81,429
Hospital list price billed
Average allowed
$17,280
Medicare's payment + patient's share
Medicare paid
$15,648
Average per service
State rank
#27 of 49
1 = lowest average payment
Hospitals in Maine billed an average of $81,429 for level 6 musculoskeletal procedures, about 4.7 times the average medicare-allowed amount of $17,280. That payment is about the same as the U.S. average of $17,392.
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 $17,280Billed $81,429
About 21¢ was paid for every $1 hospitals in Maine billed for this service.
Maine hospitals: level 6 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 | 105 | $78,094 | $17,471 | $15,839 |
| Mercy HospitalPortland | 55 | $102,188 | $17,471 | $15,839 |
| Eastern Maine Medical CenterBangor | 41 | $73,048 | $16,202 | $14,570 |
| York HospitalYork | 37 | $92,794 | $17,471 | $15,839 |
| Maine General Medical CenterWaterville | 24 | $62,036 | $18,256 | $16,624 |
| St Joseph HospitalBangor | 15 | $64,595 | $15,959 | $14,327 |
| Mid Coast HospitalBrunswick | 15 | $71,408 | $17,471 | $15,839 |
| Northern Light a R Gould HospitalPresque Isle | – | – | – | – |
| Southern Maine Health CareBiddeford | – | – | – | – |
| Central Maine Medical CenterLewiston | – | – | – | – |
| Cary Medical CenterCaribou | – | – | – | – |
| St Marys Regional Medical CenterLewiston | – | – | – | – |
| 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
| St Joseph HospitalBangor, ME | $15,959 |
|---|---|
| Eastern Maine Medical CenterBangor, ME | $16,202 |
| Mercy HospitalPortland, ME | $17,471 |
| Maine Medical CenterPortland, ME | $17,471 |
| Mid Coast HospitalBrunswick, ME | $17,471 |
Highest
| Maine General Medical CenterWaterville, ME | $18,256 |
|---|---|
| York HospitalYork, ME | $17,471 |
| Mercy HospitalPortland, ME | $17,471 |
| Maine Medical CenterPortland, ME | $17,471 |
| Mid Coast HospitalBrunswick, ME | $17,471 |
Level 6 Musculoskeletal Procedures in other states
Questions
How much does level 6 musculoskeletal procedures cost in Maine?
In 2024 Medicare data, level 6 musculoskeletal procedures (APC 5116) at 14 hospitals in Maine was billed at $81,429 on average, while the average medicare-allowed amount was $17,280, of which Medicare paid $15,648. 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 4.7 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.